| Organization Name: | CENTRAL BREVARD RADIOLOGY PA |
| NPI Number: | 1932217759 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID J HILLEREN (PRESIDENT) |
| Mailing Address: | 701 W Cocoa Beach Cswy Cocoa Beach |
| State: | FL US |
| Postal Code: | 329313585 |
| Phone Number: | 3217997192 |
| Fax Number: | 7702374866 |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 02/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |