| Organization Name: | MEDICAL ASSOCIATES OF BREVARD LLC |
| NPI Number: | 1013071489 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GERARD BESSETTE (ADMINISTRATOR) |
| Mailing Address: | 5055 Babcock St Ne # 2 Palm Bay |
| State: | FL US |
| Postal Code: | 329054673 |
| Phone Number: | 3217241200 |
| Fax Number: | 3219510675 |
| NPI Enumeration Date: | 12/20/2006 |
| NPI Last Update Date: | 09/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |