Organization
BREVARD HEALTH ALLIANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CRAIG (BILLING DIRECTOR)
(321) 241-6834
Entity
Organization
Contact information
Practice address
5270 BABCOCK ST NE, SUITE 1, PALM BAY, FL 32905-8630
(321) 722-5959
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 722-5910
(321) 733-2073
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688693100
—
FL
Enumeration date
05/24/2006
Last updated
03/04/2024
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