Organization
NEUROLOGY ASSOCIATES OF BREVARD LLC
Active
Organization
NEUROLOGY ASSOCIATES OF BREVARD LLC
Active
Other names
Neurology Associates of Brevard
Organization subpart
No
Provider details
NPI number
Authorized official
SANDI LAROCHE (MSO CREDENTIALING COORDINATOR)
(321) 449-4168
Entity
Organization
Contact information
Practice address
8055 SPYGLASS HILL RD, SUITE 102, MELBOURNE, FL 32940-8564
(321) 637-4760
(321) 637-4715
Mailing address
150 N SYKES CREEK PKWY, SUITE 300, MERRITT ISLAND, FL 32953-3488
(321) 449-4168
(321) 449-4164
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114197423
DR NPI
—
Enumeration date
04/28/2010
Last updated
06/30/2010
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