MEDICARE: CARDIOLOGY ASSOCIATES OF CENTRAL BREVARD LLC

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	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659642288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY ASSOCIATES OF CENTRAL BREVARD LLC

Provider Business Mailing Address
First Line	:	3571 S ATLANTIC AVE
Second Line	:
City	:	COCOA BEACH
State	:	FL
Zip	:	32931-2111
Country	:	US
Telephone Number	:	321-243-4936
Fax Number	:

Provider Business Practice Location Address
First Line	:	3571 S ATLANTIC AVE
Second Line	:
City	:	COCOA BEACH
State	:	FL
Zip	:	32931-2111
Country	:	US
Telephone Number	:	321-243-4936
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEWIS C BEAN
Credential	:	MD
Telephone Number	:	321-243-4936

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	03/19/2012

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