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Organization
BREVARD PATHOLOGY PA
Active
Organization
BREVARD PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCO BURENKO MD (PRESIDENT)
(321) 799-7123
Entity
Organization
Contact information
Practice address
699 W COCOA BCH CSWY, STE 203, COCOA BEACH, FL 32931
(321) 799-7123
Mailing address
657 BREVARD AVE, COCOA, FL 32922
(321) 632-6880
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
01/23/2006
Last updated
10/11/2007
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