Organization
NORTH BREVARD CHILDREN'S MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS G BARIMO M.D. (PRESIDENT)
(321) 267-5965
Entity
Organization
Contact information
Practice address
1653 JESS PARRISH CT, TITUSVILLE, FL 32796-2145
(321) 267-5965
(321) 267-8487
Mailing address
1653 JESS PARRISH CT, TITUSVILLE, FL 32796-2145
(321) 267-5965
(321) 267-8487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081197
CIGNA
FL
01
—
229946
AMERIGROUP
FL
01
—
39730
BLUE CROSS/BLUE SHIELD
FL
01
—
69355
AETNA
FL
Enumeration date
11/22/2005
Last updated
08/22/2020
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