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General NPI Number Information
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NPI Number | 1366796385
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Entity Type | Organization
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Legal Business Name | BREVARD URGENT CARE PLLC
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 2795 W NEW HAVEN AVE
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City | W MELBOURNE
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State | FL
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Zip | 32904-3705
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Country | US
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Telephone | 321-676-8732
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 411685
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City | MELBOURNE
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State | FL
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Zip | 32941-1685
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Country | US
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Telephone | 321-676-8732
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARAVIND KUMAR
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Credential | MD
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Telephone | 321-676-8732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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