MEDICARE: CIRCLES OF CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	8540	FL
2	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1518234830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLES OF CARE, INC.

Provider Business Mailing Address
First Line	:	400 E SHERIDAN RD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-3184
Country	:	US
Telephone Number	:	321-722-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 DR MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-2909
Country	:	US
Telephone Number	:	321-914-0650
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF HUMAN RESOURCES
Name	:	FALLON DEROSA
Credential	:
Telephone Number	:	321-722-5273

Provider Enumeration Date	:	12/01/2011
Last Update Date	:	02/28/2022

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