Organization
BREVARD MEDICAL DERMATOLOGY, PA
Active
Organization
BREVARD MEDICAL DERMATOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SPICER MD (PRESIDENT)
(321) 428-4737
Entity
Organization
Contact information
Practice address
7960 N. WICKHAM ROAD, SUITE 103, MELBOURNE, FL 32940-8096
(321) 428-4737
(321) 241-6457
Mailing address
7960 N. WICKHAM ROAD, SUITE 103, MELBOURNE, FL 32940-8096
(321) 428-4737
(321) 241-6457
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/18/2014
Last updated
02/21/2020
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