Brevard Pathology PA
Pathology, Anatomic Pathology & Clinical Pathology in Cocoa Beach, FL. Organization (NPI-2).
NPI number1124311964
StatusActive
Last updated in NPPESMay 26, 2011
Details
- NPI
- 1124311964
- Entity type
- Organization (NPI-2)
- Legal business name
- Brevard Pathology PA
- Organization subpart
- No
- Enumeration date
- May 26, 2011
- Last updated
- May 26, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | ME 51687 | FL | Yes |
Practice location
701 W Cocoa Beach CswyCocoa Beach, FL 32931-3585
Phone 305-666-2427 · Fax 305-667-0239
Mailing address
1500 San Remo AveSuite 280
Coral Gables, FL 33146-3043
Phone 305-666-2427 · Fax 305-666-1065
Authorized official
Marco Burenko
President
3056662427
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