| Brevard Health Alliance | |
|
500 N Washington Ave Suite 105 Titusville FL 32796-2759 | |
| (321) 264-5496 | |
| (321) 268-3357 |
| Full Name | Brevard Health Alliance |
|---|---|
| Speciality | General Practice |
| Location | 500 N Washington Ave, Titusville, Florida |
| Authorized Official Name and Position | Angela Craig (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 3219529696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Health Alliance 500 N Washington Ave Suite 105 Titusville FL 32796-2759 Ph: (321) 264-5496 | Brevard Health Alliance 500 N Washington Ave Suite 105 Titusville FL 32796-2759 Ph: (321) 264-5496 |
| NPI Number | 1336444637 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 01/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336444637 | NPI | - | NPPES |
| 6886931-13 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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