| Brevard Health Alliance Inc | |
|
17 Silver Palm Ave Melbourne FL 32901-3123 | |
| (321) 733-2021 | |
| (321) 727-0884 |
| Full Name | Brevard Health Alliance Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17 Silver Palm Ave, Melbourne, Florida |
| Authorized Official Name and Position | Angela Craig (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 3219529696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Health Alliance Inc 17 Silver Palm Ave Melbourne FL 32901-3123 Ph: (321) 733-2021 | Brevard Health Alliance Inc 17 Silver Palm Ave Melbourne FL 32901-3123 Ph: (321) 733-2021 |
| NPI Number | 1528115458 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 02/18/2014 |
| Medicare PECOS PAC ID | 0446201768 |
|---|---|
| Medicare Enrollment ID | O20050203000754 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528115458 | NPI | - | NPPES |
| 6886931-02 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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