Brevard Neuro Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME89659 Issued in FL

Legal business name

BREVARD NEURO CENTER

Practice address

315 E Nasa Blvd
Melbourne, FL 32901-1939

Phone

(321) 733-2711

Fax

(321) 733-2011

NPI assigned

Oct 22, 2013

Last updated

Sep 29, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Josse Anthony Mazo-Mayorquin, MDNPI 1447256284

Title

MD/Owner

Phone

(321) 733-2711

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHCEAD

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Josse Anthony Mazo-Mayorquin, M.D.

  • Neurology Physician
  • Melbourne, FL
  • NPI 1447256284
  Medicare reassignment Care Compare group NPD Authorized official
• Maritza Riascos, MD

  • Neurology Physician
  • Melbourne, FL
  • NPI 1922004639
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1801224290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011939",
            "telephone_number": "321-733-2711",
            "fax_number": "321-733-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011939",
            "telephone_number": "321-733-2711",
            "fax_number": "321-733-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD NEURO CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-22",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "MAZO-MAYORQUIN",
        "authorized_official_first_name": "JOSSE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "321-733-2711",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME89659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brevard Hma HME, LLC (Wuesthoff Home Medical Equipment)
• Brevard Home Care LLC (Griswold Homecare)
• Brevard Hope Center
• Brevard Hyperbarics LLC
• Brevard Medical Dermatology, PA
• Brevard Optometry Associates (Brevard Vision Care)
• Brevard Orthopaedic Spine & Pain Clinic Inc (The BACK Center)
• Brevard Orthopaedic Spine & Pain Clinic Inc (The BACK CENTER)
• Brevard Orthopaedics Spine & Pain Clinic, Inc (The BACK Center)
• Brevard Pathology PA

• Specialist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.