Organization
CANCER CARE CENTERS OF BREVARD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SILAS J. CHARLES M.D. (PRESIDENT)
(321) 952-0898
Entity
Organization
Contact information
Practice address
1430 S. PINE ST., MELBOURNE, FL 32901-3119
(321) 952-0898
(321) 952-6296
Mailing address
PO BOX 100045, ATLANTA, GA 30348-0045
(321) 952-0898
(321) 952-6296
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RX0202X
Medical Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372996600
—
FL
05
—
372996601
—
FL
05
—
372996602
—
FL
05
—
372996603
—
FL
05
—
372996604
—
FL
05
—
372996605
—
FL
05
—
372996606
—
FL
05
—
372996618
—
FL
05
—
372996619
—
FL
05
—
372996620
—
FL
05
—
372996623
—
FL
01
—
CL7578
RR MEDICARE
FL
Enumeration date
09/22/2006
Last updated
07/26/2023
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