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Organization

CANCER CARE CENTERS OF BREVARD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. GAIL K ERENTREICH (DIRECTOR OF CLINICAL SERVICES)
(321) 636-2111
Entity
Organization

Contact information

Practice address
1048 HARVIN WAY, ROCKLEDGE, FL 32955
(321) 636-2111
(321) 636-7180
Mailing address
1048 HARVIN WAY, ROCKLEDGE, FL 32955
(321) 636-2111
(321) 636-7180

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
64498
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
265641800
FL
01
39835
GROUP MEDICARE
FL
Enumeration date
07/28/2014
Last updated
08/31/2020
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