NPIMap

Organization Active NPI

Cancer Care Centers of Brevard Inc

  • Hematology & Oncology Physician
  • West Melbourne, FL
National Provider Identifier
1801561709
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
CANCER CARE CENTERS OF BREVARD INC
Practice address
1541 S Wickham Rd
West Melbourne, FL 32904-3540
Phone
(321) 725-8300
Fax
(321) 725-1555
NPI assigned
Aug 12, 2021
Last updated
Aug 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Gail Knight Erentreich
Title
Director of Clinical Operations
Phone
(321) 636-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X Primary

Addresses

Primary practice location

1541 S Wickham Rd
West Melbourne, FL 32904-3540

Mailing address

1048 Harvin Way
Rockledge, FL 32955-3229
Phone (132) 163-6211

National Provider Directory

National Provider Directory
Tax ID family
Cancer Care Centers of Brevard Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1801561709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 HARVIN WAY",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553229",
            "telephone_number": "132-163-6211",
            "fax_number": "321-636-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 S WICKHAM RD",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043540",
            "telephone_number": "321-725-8300",
            "fax_number": "321-725-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE CENTERS OF BREVARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "ERENTREICH",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "KNIGHT",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "321-636-2111"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.