Brevard Dermpath and Surgpath Lab Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

BREVARD DERMPATH AND SURGPATH LAB INC

Practice address

830 Executive LN
Suite #150
Rockledge, FL 32955-3595

Phone

(305) 702-5135

NPI assigned

Sep 20, 2006

Last updated

Jun 10, 2008By 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. Sumant Pandya, MDNPI 1538135116

Title

President

Phone

(305) 702-5135

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Sumant J Pandya, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Rockledge, FL
  • NPI 1538135116
  NPD (past) Authorized official
• Julie D Bell, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Vero Beach, FL
  • NPI 1417923095
  NPD (past)
• Shondell M Bouie, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Rockledge, FL
  • NPI 1982826806
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1942307178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 PONCE DE LEON BLVD",
            "address_2": "4TH FLOOR",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346010",
            "telephone_number": "305-702-5135",
            "fax_number": "305-441-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EXECUTIVE LN",
            "address_2": "SUITE #150",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553595",
            "telephone_number": "305-702-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD DERMPATH AND SURGPATH LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "SUMANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-702-5135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brevard County Board of County Commissioner (Brevard County Fire Rescue)
• Brevard Ear Nose & Throat Center PA
• Brevard Eye Associates
• Brevard Family Walk in Clinic LLC
• Brevard Family Walk in Clinic Rockledge (Brevard Family Walk In Clinic LLC)
• Brevard Health Alliance Inc

• Anatomic Pathology & Clinical Pathology Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.