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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