Organization
OB/GYN SPECIALISTS OF BREVARD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN BRUCE HAYES M.D. (MEDICAL DOCTOR/OWNER)
(321) 733-2201
Entity
Organization
Contact information
Practice address
1555 W NASA BLVD, MELBOURNE, FL 32901-2640
(321) 733-2201
(321) 733-2202
Mailing address
1555 W NASA BLVD, MELBOURNE, FL 32901-2640
(321) 733-2201
(321) 733-2202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME69211
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259101400
—
FL
Enumeration date
09/20/2006
Last updated
10/12/2011
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