| NPI | 1578508966 |
|---|---|
| Former Legal Business Name | BREVARD MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ROBERT H PAXSON Authorized Official 321-453-3638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2022-07-21 |