Healthcare Provider Details

I. General information

NPI: 1932256047
Provider Name (Legal Business Name): MEGHAN JUDITH VIEGAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 S BREVARD AVE
COCOA BEACH FL
32931-2797
US

IV. Provider business mailing address

720 E NEW HAVEN AVE
MELBOURNE FL
32901-5474
US

V. Phone/Fax

Practice location:
  • Phone: 321-260-2101
  • Fax: 321-641-6594
Mailing address:
  • Phone: 321-724-4545
  • Fax: 321-728-4168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9271932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: