Organization
BREVARD HEALTH ALLIANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CRAIG (BUSINESS OFFICE MANAGER)
(321) 952-9696
Entity
Organization
Contact information
Practice address
1537 N SINGLETON AVE, TITUSVILLE, FL 32796-1679
(321) 268-0267
(321) 267-3742
Mailing address
1537 N SINGLETON AVE, TITUSVILLE, FL 32796-1679
(321) 268-0267
(321) 267-3742
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6886931-12
—
FL
Enumeration date
08/13/2010
Last updated
11/28/2022
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