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NPI Code Detail

MEDICARE: CANCER CARE CENTERS OF BREVARD INC

MEDICARE: CANCER CARE CENTERS OF BREVARD INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician

General Provider Information

NPI Number : 1114590429
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANCER CARE CENTERS OF BREVARD INC
Provider Business Mailing Address
First Line : 1430 PINE ST
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3119
Country : US
Telephone Number : 321-674-5050
Fax Number :
Provider Business Practice Location Address
First Line : 20 SAN FILIPPO DR SE
Second Line :
City : PALM BAY
State : FL
Zip : 32909-2200
Country : US
Telephone Number : 321-725-8300
Fax Number : 321-725-1555
Authorized Official
Title or Position : DIRECTOR OF CLINICAL OPERATIONS
Name : GAIL KNIGHT ERENTREICH
Credential :
Telephone Number : 321-636-2111
Provider Enumeration Date : 07/23/2021
Last Update Date : 07/23/2021

Similar Medicare Providers

1952362816 — GREGORY B HOANG MD
Practice Location Address:
20 SAN FILIPPO DR SE
PALM BAY, FL
32909-2200
Practice Phone: 321-725-8300
Practice Fax: 321-725-1555
1891855532 — KATIE L WILKERSON ARNP
Practice Location Address:
20 SAN FILIPPO DR SE
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32909-2200
Practice Phone: 321-725-8300
Practice Fax: 321-725-1555
1205091758 — VENKAT PAVAN REDDY KANCHARLA M.D
Practice Location Address:
20 SAN FILIPPO DR SE
PALM BAY, FL
32909-2200
Practice Phone: 321-725-8300
Practice Fax: 321-725-1555
1023254240 — KAREN PAZ P.A.
Practice Location Address:
20 SAN FILIPPO DR SE
PALM BAY, FL
32909-2200
Practice Phone: 321-725-8300
Practice Fax: 321-725-1555
1609105246 — TRICIA K' SOLITO DNP, ARNP
Practice Location Address:
20 SAN FILIPPO DR SE
PALM BAY, FL
32909-2200
Practice Phone: 321-725-8300
Practice Fax: 321-725-1555
1902804636 — MATTHEW CUSUMANO D.O.
Practice Location Address:
2200 W BAY DR
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33770-1929
Practice Phone: 727-518-2977
Practice Fax: 727-518-0010

Directions to “CANCER CARE CENTERS OF BREVARD INC ” Practice Location

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