# BREVARD PATHOLOGY SERVICES PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982002473
- **Authorized official:** DR. CHARLES CHODOROW MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (321) 953-4804

## Contact information

- **Practice address:** 1350 HICKORY ST, MELBOURNE, FL 32901-3224
- **Practice address phone:** (321) 953-4804
- **Practice address fax:** (321) 728-7176
- **Mailing address:** 2080 S RIVER RD, MELBOURNE BEACH, FL 32951-2928
- **Mailing address phone:** (321) 953-4804
- **Mailing address fax:** (321) 728-7176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2014
- **Last updated:** 01/02/2015