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Organization

THE BREVARD HEALTH ALLIANCE INC

Active
Other names
Port St John Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA CRAIG (BUSINESS OFFICE MANAGER)
(321) 241-6834
Entity
Organization

Contact information

Practice address
7227 N US HIGHWAY 1, COCOA, FL 32927-5020
(321) 877-2740
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
05/31/2016
Last updated
05/31/2016
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