Organization
BREVARD ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNIE MESAROS R.PH (CEO/OWNER)
(321) 693-4269
Entity
Organization
Contact information
Practice address
3831 FUNSTON CIR, MELBOURNE, FL 32940-8583
(321) 693-4269
(321) 406-0298
Mailing address
9060 S TROPICAL TRL, MERRITT ISLAND, FL 32952-6803
(321) 693-4269
(321) 406-0298
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11779
FL
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up