Organization
BREVARD PHYSICIAN ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY BROWN M.D. (MEMBER)
(321) 255-9671
Entity
Organization
Contact information
Practice address
1775 W HIBISCUS BLVD STE 215, MELBOURNE, FL 32901-2627
(321) 837-3820
Mailing address
PO BOX 2400, MELBOURNE, FL 32902-2400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207P00000X
Emergency Medicine Physician
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104036300
—
FL
01
—
LQ014
FL MEDICARE
FL
Enumeration date
04/03/2013
Last updated
12/15/2023
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