BREVARD HEALTH ALLIANCE NPI 1952451239

NPI Information

  • NPI: 1952451239
  • Provider Name: BREVARD HEALTH ALLIANCE
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Address: 15 ROSA L JONES BLVD
    COCOA, FL
    ZIP 32922
  • Phone: (321) 639-5177

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NPI Details

BREVARD HEALTH ALLIANCE is a federally qualified health center (fqhc) clinic center in Cocoa, FL. BREVARD HEALTH ALLIANCE NPI is 1952451239. The provider is registered as an organization entity type.

The provider's business location address is:

15 ROSA L JONES BLVD
COCOA, FL
ZIP 32922-899
Phone: (321) 639-5177

The provider's authorized official is Marsha Vendetti .
The authorized official title is Operations Manager and has the following contact phone number (321) 722-5970.

The enumeration date for this NPI number is 1/11/2007 and was last updated on 11/4/2010.

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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110-1985MEDICARE ID-TYPE UNSPECIFIED
26886931-09MEDICAIDFLORIDA

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: 3/30/2025

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