MEDICARE: DR. JAMES ALAN BRIX D. MIN., L. P. C.

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	101YM0800X	Mental Health Counselor	37PC00291700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37PC00291700	OTHER	NJ	LICENSED PROFESSIONAL COU

General Provider Information

NPI Number	:	1912108812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ALAN BRIX D. MIN., L. P. C.

Provider Business Mailing Address
First Line	:	2803 SONOMA WAY
Second Line	:
City	:	VIERA
State	:	FL
Zip	:	32955-5179
Country	:	US
Telephone Number	:	321-636-5986
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 TOWNSHIP LINE RD
Second Line	:	BUILDING A, 2ND FLOOR
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-3867
Country	:	US
Telephone Number	:	908-359-3269
Fax Number	:	908-359-0274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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