Organization
NORTH BREVARD MEDICAL SUPPORT, INC
Active
Organization
NORTH BREVARD MEDICAL SUPPORT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT ANDREW BAILEY (VP FINANCE)
(321) 268-6111
Entity
Organization
Contact information
Practice address
250 HARRISON ST STE 100, TITUSVILLE, FL 32780-5098
(321) 268-6674
(321) 268-6138
Mailing address
805 CENTURY MEDICAL DR STE C, TITUSVILLE, FL 32796-2100
(212) 686-2643
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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