| Brevard Health Alliance | |
|
5270 Babcock St Ne # St1 Palm Bay FL 32905-8630 | |
| (321) 722-5959 | |
| Not Available |
| Full Name | Brevard Health Alliance |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5270 Babcock St Ne # St1, Palm Bay, Florida |
| Authorized Official Name and Position | Marsha Vendetti (OPERATIONS MANAGER) |
| Authorized Official Contact | 3217225970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Health Alliance 5270 Babcock St Ne # St1 Palm Bay FL 32905-8630 Ph: (321) 722-5959 | Brevard Health Alliance 5270 Babcock St Ne # St1 Palm Bay FL 32905-8630 Ph: (321) 722-5959 |
| NPI Number | 1679622120 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 11/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679622120 | NPI | - | NPPES |
| 6886931-01 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Brevard Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5270 Babcock St Ne # St1, Palm Bay, FL 32905 Phone: 321-722-5973 | |
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