Organization
BREVARD SPECIALTY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN FITZGERALD MD (PRESIDENT)
(321) 952-9800
Entity
Organization
Contact information
Practice address
95 BULLDOG BOULEVARD, SUITE 104, MELBOURNE, FL 32901-3175
(321) 952-9800
(321) 952-7889
Mailing address
95 BULLDOG BOULEVARD, SUITE 104, MELBOURNE, FL 32901-3175
(321) 952-9800
(321) 952-7889
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
846
FL
261QA1903X
Ambulatory Surgical Clinic/Center
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Other
Enumeration date
09/15/2009
Last updated
04/15/2010
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