Central Brevard Radiology PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CENTRAL BREVARD RADIOLOGY PA

Practice address

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3585

Phone

(321) 799-7192

Fax

(770) 237-4866

NPI assigned

Aug 29, 2006

Last updated

Feb 9, 2012By 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

Dr. David J Hilleren, MDNPI 1871501791

Title

President

Phone

(321) 799-7192

Specialties & licenses 6

Addresses

Other identifiers 3

Practitioners 1

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.

• David J Hilleren, M.D.

  • Diagnostic Radiology Physician
  • Cocoa Beach, FL
  • NPI 1871501791
  Authorized official Same address or phone

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1932217759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881839",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349881839",
            "telephone_number": "727-896-3134",
            "fax_number": "770-621-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313585",
            "telephone_number": "321-799-7192",
            "fax_number": "770-237-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BREVARD RADIOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "HILLEREN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-799-7192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39812",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058771100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CA4481",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Robin Carlson, SPEECH LANGUAGE PATH
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• Charles E Chamas, DPM
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• Jose Andres Chavac Rodas, APRN
• David Che, D.D.S

• Diagnostic Radiology Physician in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.