| NPI | 1356795892 |
|---|---|
| Former Legal Business Name | BREVARD PAIN MANAGEMENT, INC. |
| Entity Type | Organization |
| Authorized Contact | TODD B JAFFE Owner 321-757-0577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME00396795) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME0039795) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2017-03-14 |