Organization
BREVARD PSYCHIATRY & PSYCHOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE RAFAEL GONZALEZ-SOLTERO MD (OWNER)
(321) 751-1925
Entity
Organization
Contact information
Practice address
6767 N WICKHAM ROAD, SUITE 306, MELBOURNE, FL 32940
(321) 751-1925
(321) 751-9261
Mailing address
6767 N WICKHAM ROAD, SUITE 306, MELBOURNE, FL 32940
(321) 751-1925
(321) 751-9261
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
01/10/2007
Last updated
07/14/2008
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