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Organization
TNT ENTERPRISES OF BREVARD INC.
Active
Organization
TNT ENTERPRISES OF BREVARD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD WILLIAMS P.A. (OWNER/PHYSICIANS ASSISTANT)
(321) 288-4068
Entity
Organization
Contact information
Practice address
1350 S HICKORY ST, MELBOURNE, FL 32901-3278
(321) 288-4068
Mailing address
PO BOX 411863, MELBOURNE, FL 32941-1863
(321) 288-4068
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9100882
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X1620
BLUE CROSS
FL
Enumeration date
05/19/2006
Last updated
08/22/2020
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