NPI 1225682784

Brevard Geriatrics, LLC

Organisation Geriatric Medicine (Family Medicine) Physician Melbourne, FL

Practice location

Address: 720 E New Haven Ave Suite 11, Melbourne, FL 32901-5474
Phone: (321) 724-4545
Fax: (321) 728-4168

Authorised official

Name: John Potomski
Title: Owner
Phone: (321) 446-5893

Registered specialties

Geriatric Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QG0300X

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Registry record

NPI: 1225682784
Entity type: Organization
NPI issued: 1 Aug 2019
Record last updated: 1 Aug 2019

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.