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NORTH BREVARD MEDICAL SUPPORT INC NPI 1033883764


NPI Information

NPI: 1033883764
Provider Name: NORTH BREVARD MEDICAL SUPPORT, INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D1047862

Address:
5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL
ZIP 32927
Phone: (321) 504-0556
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NORTH BREVARD MEDICAL SUPPORT, INC is a family medicine in Port St John, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NORTH BREVARD MEDICAL SUPPORT, INC NPI is 1033883764. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5005 PORT ST JOHN PKWY STE 2500
PORT ST JOHN, FL
ZIP 32927-305
Phone: (321) 504-0556
Fax: (321) 504-0773

The provider's authorized official is Kent Andrew Bailey .
The authorized official title is Vp Finance and has the following contact phone number (321) 268-6111.

The CLIA number assigned to this NPI record is 10D1047862 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2021 and was last updated on 8/5/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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