Organization
GI ASSOCIATES OF BREVARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDI LAROCHE (MSO CREDENTIALING COORDINATOR)
(321) 449-4168
Entity
Organization
Contact information
Practice address
1004 BEVERLY DR, SUITE B, ROCKLEDGE, FL 32955-2851
(321) 637-7655
Mailing address
150 N SYKES CREEK PKWY, #300, MERRITT ISLAND, FL 32953-3488
(321) 449-4168
(321) 449-4164
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME49690
FL
Other
Enumeration date
05/05/2008
Last updated
04/07/2009
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