Organization
FLORIDA HEALTH CARE OF BREVARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS LOPEZ (OWNER)
(722) 226-6859
Entity
Organization
Contact information
Practice address
1840 ELDRON BLVD SE STE 2, PALM BAY, FL 32909-6871
(561) 523-3973
Mailing address
1840 ELDRON BLVD SE STE 2, PALM BAY, FL 32909-6871
(772) 226-6859
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2019
Last updated
03/05/2024
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