| North Brevard Medical Support, Inc | |
|
5005 Port St John Pkwy Ste 2300 Port St John FL 32927-4305 | |
| (321) 633-8660 | |
| (321) 633-8617 |
| Full Name | North Brevard Medical Support, Inc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 5005 Port St John Pkwy Ste 2300, Port St John, Florida |
| Authorized Official Name and Position | Kent Andrew Bailey (VP FINANCE) |
| Authorized Official Contact | 3212686111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Brevard Medical Support, Inc 805 Century Medical Dr Ste C Titusville FL 32796-2100 Ph: (321) 268-6264 | North Brevard Medical Support, Inc 5005 Port St John Pkwy Ste 2300 Port St John FL 32927-4305 Ph: (321) 633-8660 |
| NPI Number | 1396419032 |
|---|---|
| Provider Enumeration Date | 08/05/2021 |
| Last Update Date | 08/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396419032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
North Brevard Medical Support, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Port St John Pkwy Ste 2500, Port St John, FL 32927 Phone: 321-504-0556 Fax: 321-504-0773 | |
Gaurav N Mathur Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7139 N Us Highway 1, Port St John, FL 32927 Phone: 321-621-0476 | |
North Brevard Medical Support, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5005 Port St John Pkwy Ste 2600, Port St John, FL 32927 Phone: 321-504-7375 Fax: 321-504-0737 |