Organization
NORTH BREVARD MEDICAL SUPPORT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT ANDREW BAILEY (VP FINANCE)
(321) 268-6111
Entity
Organization
Contact information
Practice address
5005 PORT ST JOHN PKWY STE 2300, PORT ST JOHN, FL 32927-4305
(321) 633-8660
(321) 633-8617
Mailing address
805 CENTURY MEDICAL DR STE C, TITUSVILLE, FL 32796-2100
(321) 268-6264
(321) 268-6273
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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