BREVARD HEALTH ALLIANCE NPI 1528330826

NPI Information

NPI: 1528330826
Provider Name: BREVARD HEALTH ALLIANCE
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 10D0874863

Address:
775 MALABAR RD
MALABAR, FL
ZIP 32950
Phone: (321) 722-8435
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BREVARD HEALTH ALLIANCE is a federally qualified health center (fqhc) clinic center in Malabar, FL. BREVARD HEALTH ALLIANCE NPI is 1528330826. The provider is registered as an organization entity type.

The provider's business location address is:

775 MALABAR RD
MALABAR, FL
ZIP 32950-120
Phone: (321) 722-8435
Fax: (321) 722-8486

The provider's authorized official is Angela Craig .
The authorized official title is Business Office Manager and has the following contact phone number (321) 952-9696.

The CLIA number assigned to this NPI record is 10D0874863 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/1/2012 and was last updated on 2/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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