Organization
BREVARD OPTOMETRY ASSOCIATES
Active
Other names
Brevard Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RITA E. JIMENEZ (PRACTICE MANAGER)
(321) 725-4755
Entity
Organization
Contact information
Practice address
2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
(321) 725-4755
(321) 725-5088
Mailing address
2420 S BABCOCK ST, MELBOURNE, FL 32901-5356
(321) 725-4755
(321) 725-5088
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC0891
FL
152W00000X
Optometrist
Primary
OPC1857
FL
152W00000X
Optometrist
OPC2189
FL
152W00000X
Optometrist
OPC2747
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC4006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078286600
—
FL
05
—
078627600
—
FL
05
—
078847300
—
FL
05
—
620059100
—
FL
05
—
621109700
—
FL
Enumeration date
11/08/2006
Last updated
02/13/2008
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