Organization
BREVARD PRIMARY CARE LLC
Active
Organization
BREVARD PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHAVANI M PUSKUR M.D. (PRACTICE OWNER)
(321) 948-8555
Entity
Organization
Contact information
Practice address
2328 CITADEL WAY STE 103-319, MELBOURNE, FL 32940-6459
(321) 757-1900
(866) 376-2481
Mailing address
2328 CITADEL WAY STE 103-319, MELBOURNE, FL 32940-6459
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
06/26/2014
Last updated
11/15/2024
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