Healthcare Provider Details

I. General information

NPI: 1407780026
Provider Name (Legal Business Name): SAINT MARY MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4651 BABCOCK ST NE STE 5A
PALM BAY FL
32905-2808
US

IV. Provider business mailing address

4651 BABCOCK ST NE STE 5A
PALM BAY FL
32905-2808
US

V. Phone/Fax

Practice location:
  • Phone: 321-914-0484
  • Fax: 321-914-0563
Mailing address:
  • Phone: 321-914-0484
  • Fax: 321-914-0563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARINA BAKHET
Title or Position: OWNER
Credential:
Phone: 321-914-0484