Organization
BREVARD PATHOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCO BURENKO MD (PRESIDENT)
(305) 666-2427
Entity
Organization
Contact information
Practice address
8745 N WICKHAM RD, MELBOURNE, FL 32940-5997
(305) 666-2427
(305) 667-0239
Mailing address
1500 SAN REMO AVE, SUITE 280, CORAL GABLES, FL 33146-3043
(305) 666-2427
(305) 666-1065
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME 51687
FL
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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