| Brevard Health Care Llc | |
|
240 N Wickham Rd Suite 202 Melbourne FL 32935-8662 | |
| (321) 259-5999 | |
| (321) 259-5553 |
| Full Name | Brevard Health Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 240 N Wickham Rd, Melbourne, Florida |
| Authorized Official Name and Position | Brandy J Marczuk (OFFICE MANAGER) |
| Authorized Official Contact | 3212595999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Health Care Llc 240 N Wickham Rd Suite 202 Melbourne FL 32935-8662 Ph: (321) 259-5999 | Brevard Health Care Llc 240 N Wickham Rd Suite 202 Melbourne FL 32935-8662 Ph: (321) 259-5999 |
| NPI Number | 1427271345 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 04/22/2010 |
| Medicare PECOS PAC ID | 7719014794 |
|---|---|
| Medicare Enrollment ID | O20100422000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427271345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME81535 (Florida) | Primary |
| Provider Name | Marissa H Rocourt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689758690 PECOS PAC ID: 2163559154 Enrollment ID: I20100511000244 |
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