Organization
BREVARD HEALTH GROUP LLC
Active
Parent organization
BREVARD HEALTH GROUP LLC
Other names
Brevard Spine and Rehab Institute
Organization subpart
Yes
Provider details
NPI number
Legal business name
BREVARD HEALTH GROUP LLC
Authorized official
VIJAY KATUKURI MD (OWNER)
(248) 707-0920
Entity
Organization
Contact information
Practice address
1301 W EAU GALLIE BLVD STE 112, MELBOURNE, FL 32935
(321) 327-9788
(321) 320-7636
Mailing address
30 MOUNTAIN TER, ASHEVILLE, NC 28806-1924
(828) 450-7064
(855) 422-2581
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
09/07/2018
Last updated
10/10/2018
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