| Organization Name: | BREVARD INTERNAL MEDICINE & WALK-IN CLINIC |
| NPI Number: | 1710216262 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ARAVIND KUMAR (SOLE OWNER) |
| Mailing Address: | 2795 W New Haven Ave W Melbourne |
| State: | FL US |
| Postal Code: | 329043705 |
| Phone Number: | 3216228626 |
| Fax Number: | 3216228627 |
| NPI Enumeration Date: | 12/11/2009 |
| NPI Last Update Date: | 02/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ARNP 2107012 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |