# BREVARD OPTOMETRY ASSOCIATES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Brevard Vision Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710057054
- **Authorized official:** MS. RITA E. JIMENEZ (PRACTICE MANAGER)
- **Authorized official phone:** (321) 725-4755

## Contact information

- **Practice address:** 2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
- **Practice address phone:** (321) 725-4755
- **Practice address fax:** (321) 725-5088
- **Mailing address:** 2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
- **Mailing address phone:** (321) 725-4755
- **Mailing address fax:** (321) 725-5088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC0891 | FL | — |
| 152W00000X | Optometrist | OPC1857 | FL | Yes |
| 152W00000X | Optometrist | OPC2189 | FL | — |
| 152W00000X | Optometrist | OPC2747 | FL | — |
| 152WC0802X | Corneal and Contact Management Optometrist | OPC4006 | FL | — |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 02/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 078286600 | — | FL |
| 05 | — | 078627600 | — | FL |
| 05 | — | 078847300 | — | FL |
| 05 | — | 620059100 | — | FL |
| 05 | — | 621109700 | — | FL |