NPI 1184806630

Brevard Vascular Associates LLC

Organisation Vascular Surgery Physician Rockledge, FL

Practice location

Address: 1004 Beverly Dr Suite D, Rockledge, FL 32955-2851
Phone: (321) 637-4710
Fax: (321) 637-4715
Mailing address: 150 N Sykes Creek Pkwy Suite 300, Merritt Island, FL 32953-3488

Authorised official

Name: Sandi Laroche
Title: Mso Credentialing Coordinator
Phone: (321) 449-4168

Registered specialties

Vascular Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2086S0129X Licence ME91509 (FL)

Other Surgery providers in Florida →

Registry record

NPI: 1184806630
Entity type: Organization
NPI issued: 27 Nov 2007
Record last updated: 4 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.