Healthcare Provider Details
I. General information
NPI: 1861615130
Provider Name (Legal Business Name): AMIT C BAROCHIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/11/2007
Last Update Date: 06/04/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8725 N WICKHAM RD
MELBOURNE FL
32940-2239
US
IV. Provider business mailing address
3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US
V. Phone/Fax
- Phone: 321-253-4673
- Fax: 321-253-4338
- Phone: 321-253-4673
- Fax: 321-951-7408
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | ME126059 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | ME126059 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | ME126059 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: