MEDICARE: SAINT MARY MEDICAL

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
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1407780026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT MARY MEDICAL

Provider Business Mailing Address
First Line	:	4651 BABCOCK ST NE STE 5A
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2808
Country	:	US
Telephone Number	:	321-914-0484
Fax Number	:	321-914-0563

Provider Business Practice Location Address
First Line	:	4651 BABCOCK ST NE STE 5A
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2808
Country	:	US
Telephone Number	:	321-914-0484
Fax Number	:	321-914-0563

Authorized Official
Title or Position	:	OWNER
Name	:	MARINA BAKHET
Credential	:
Telephone Number	:	321-914-0484

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “SAINT MARY MEDICAL ” Practice Location

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