| Brevard Psychiatry Llc | |
|
759 Glengarry Dr Melbourne FL 32940-1867 | |
| (801) 609-8388 | |
| (801) 797-0245 |
| Full Name | Brevard Psychiatry Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 759 Glengarry Dr, Melbourne, Florida |
| Authorized Official Name and Position | Joseph Sin (PRESIDENT) |
| Authorized Official Contact | 8016098388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Psychiatry Llc 759 Glengarry Dr Melbourne FL 32940-1867 Ph: (801) 609-8388 | Brevard Psychiatry Llc 759 Glengarry Dr Melbourne FL 32940-1867 Ph: (801) 609-8388 |
| NPI Number | 1730828286 |
|---|---|
| Provider Enumeration Date | 06/02/2022 |
| Last Update Date | 08/31/2022 |
| Certification Date | 08/31/2022 |
| Medicare PECOS PAC ID | 8921487000 |
|---|---|
| Medicare Enrollment ID | O20220621000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730828286 | NPI | - | NPPES |
| PF675 | Other | FL | FL MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Joseph Sin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164866299 PECOS PAC ID: 7416204250 Enrollment ID: I20180724004043 |
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