Organization
PEDIATRICS IN BREVARD, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA LOISELLE (CREDENTIALING COORDINATOR)
(321) 877-4438
Entity
Organization
Contact information
Practice address
699 W COCOA BEACH CSWY STE 401, COCOA BEACH, FL 32931-3562
(321) 784-5437
(321) 799-1231
Mailing address
699 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-3577
(321) 784-5437
(321) 799-1231
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253255705
—
FL
Enumeration date
11/02/2005
Last updated
07/13/2021
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