Organization
CANCER CARE CENTERS OF BREVARD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SILAS J CHARLES MD (PRESIDENT)
(321) 952-0898
Entity
Organization
Contact information
Practice address
13050 US HIGHWAY 1, SEBASTIAN, FL 32958-3733
(321) 952-0898
(321) 952-6296
Mailing address
PO BOX 534595, ATLANTA, GA 30353-4595
(321) 952-0898
(321) 952-6296
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372996605
—
FL
01
—
CL7578
RR MEDICARE
FL
Enumeration date
06/05/2008
Last updated
11/24/2009
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