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
825 CENTURY MEDICAL DR STE B, TITUSVILLE, FL 32796-2113
(321) 268-6216
(321) 268-6895
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
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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