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Organization

BREVARD PHYSICAL MEDICINE

Active
Other names
Carnol Health Services
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN CHARLES MADLENER M.D (MEDICAL DOCTOR)
(321) 751-5351
Entity
Organization

Contact information

Practice address
6420 3RD STREET, SUITE 103, ROCKLEDGE, FL 32955
(321) 751-5351
(321) 751-5370
Mailing address
6420 3RD STREET, SUITE 103, ROCKLEDGE, FL 32955
(321) 751-5351
(321) 751-5370

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME86688
FL
225100000X
Physical Therapist
FL
363A00000X
Physician Assistant
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
267338000
FL
Enumeration date
04/17/2014
Last updated
04/29/2015
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