Healthcare Provider Details

I. General information

NPI: 1558456681
Provider Name (Legal Business Name): BREVARD EYE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 S APOLLO BLVD
MELBOURNE FL
32901-1485
US

IV. Provider business mailing address

665 S APOLLO BLVD
MELBOURNE FL
32901-1485
US

V. Phone/Fax

Practice location:
  • Phone: 321-984-2346
  • Fax: 321-984-2620
Mailing address:
  • Phone: 321-984-3200
  • Fax: 321-984-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFAEL TRESPALACIOS
Title or Position: OWNER
Credential: MD
Phone: 321-984-3200