Brevard Geriatrics, Llc

LBN: Brevard Geriatrics, Llc
Brevard Geriatrics, Llc is an health care organization with primary practice located at 720 E New Haven Ave Suite 11 , Melbourne FL 32901-5474. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as the primary health care specialty. Brevard Geriatrics, Llc can be contacted via phone (321) 724-4545, or through Potomski, John via phone (321) 446-5893.

Contact Information

Primary practice address
720 E New Haven Ave Suite 11 Melbourne FL 32901-5474
Phone: (321) 724-4545
Fax: (321) 728-4168
Website:
Map and Directions
Authorized official contact:
Name: Potomski, John Doctor of Osteopathy (DO)
Phone: (321) 446-5893

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X

Profile Details

NPI number 1225682784
LBN Legal business name Brevard Geriatrics, Llc
DBA Doing business as
Authorized official Potomski, John Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2019
Last updated Aug 1st, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225682784 NPPES
Florida MEDICAID 067596200

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