| Medical Associates Of Brevard Llc | |
|
2200 W Eau Gallie Blvd Suite 200 Melbourne FL 32935 | |
| (321) 253-2900 | |
| (321) 435-0100 |
| Full Name | Medical Associates Of Brevard Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2200 W Eau Gallie Blvd, Melbourne, Florida |
| Authorized Official Name and Position | Gerard L. Bessette (ADMINISTRATOR) |
| Authorized Official Contact | 3212532900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Associates Of Brevard Llc Po Box 361095 Melbourne FL 32936-1095 Ph: (321) 253-2900 | Medical Associates Of Brevard Llc 2200 W Eau Gallie Blvd Suite 200 Melbourne FL 32935 Ph: (321) 253-2900 |
| NPI Number | 1861400103 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 02/08/2024 |
| Medicare PECOS PAC ID | 4486558012 |
|---|---|
| Medicare Enrollment ID | O20090123000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861400103 | NPI | - | NPPES |
| 250155400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Gopal Gadodia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306842984 PECOS PAC ID: 1759285380 Enrollment ID: I20031125000077 |
| Provider Name | Daniel A Cohen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710096862 PECOS PAC ID: 3577462407 Enrollment ID: I20040108000657 |
| Provider Name | Simmy J Pinto |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235197781 PECOS PAC ID: 0446152326 Enrollment ID: I20040122000014 |
| Provider Name | Jagdeep Chhindra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518026137 PECOS PAC ID: 7719880137 Enrollment ID: I20040131000176 |
| Provider Name | Aleksander R Komar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720062516 PECOS PAC ID: 1850285966 Enrollment ID: I20040210000846 |
| Provider Name | Mark Raymond Hanley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063487676 PECOS PAC ID: 4385539618 Enrollment ID: I20040217000233 |
| Provider Name | Luis Armando Del Rosario Cabral |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1912988668 PECOS PAC ID: 5395713655 Enrollment ID: I20040923000805 |
| Provider Name | Rajesh K Desai |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427057256 PECOS PAC ID: 6406825868 Enrollment ID: I20041001000412 |
| Provider Name | Joven Tan Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992865679 PECOS PAC ID: 5193786333 Enrollment ID: I20041021000575 |
| Provider Name | Randi L Meberg |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710096805 PECOS PAC ID: 4385608173 Enrollment ID: I20041116000264 |
| Provider Name | Miguel L Lorente |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164448072 PECOS PAC ID: 7517918683 Enrollment ID: I20050207000109 |
| Provider Name | Nikhita Dhruv |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710985593 PECOS PAC ID: 1355388430 Enrollment ID: I20050411000479 |
| Provider Name | Mudanai Panneerselvam Sabapathy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063498327 PECOS PAC ID: 0648200683 Enrollment ID: I20050818000713 |
| Provider Name | Peter S Dovgan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1396857611 PECOS PAC ID: 6002835063 Enrollment ID: I20051121000142 |
| Provider Name | Anju Grover |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316979529 PECOS PAC ID: 9638192677 Enrollment ID: I20060105000415 |
| Provider Name | James T Go |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1053388728 PECOS PAC ID: 9234152117 Enrollment ID: I20060105000795 |
| Provider Name | Ronald A Turck |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154354561 PECOS PAC ID: 4082617675 Enrollment ID: I20060822000103 |
| Provider Name | Adwait Jathal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972574333 PECOS PAC ID: 8921040189 Enrollment ID: I20070226000111 |
| Provider Name | Nitin Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750478392 PECOS PAC ID: 5395845481 Enrollment ID: I20070725000753 |
| Provider Name | Madhavi T Chary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952544371 PECOS PAC ID: 6305996786 Enrollment ID: I20090604000656 |
| Provider Name | Esmat A Gayed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811007651 PECOS PAC ID: 6800946807 Enrollment ID: I20100407000065 |
| Provider Name | Shakti D Bakshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548249535 PECOS PAC ID: 4183774185 Enrollment ID: I20100504000782 |
| Provider Name | Adinarayana M Lagudu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720153208 PECOS PAC ID: 9739180217 Enrollment ID: I20100510000487 |
| Provider Name | Parvesh K Bansal |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548293442 PECOS PAC ID: 8729138722 Enrollment ID: I20100609000343 |
| Provider Name | John Turse |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174505531 PECOS PAC ID: 3779657689 Enrollment ID: I20100614000903 |
| Provider Name | Sudeshna Mitra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831153469 PECOS PAC ID: 8729111521 Enrollment ID: I20100730000355 |
| Provider Name | Christopher Scott Nunes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508821265 PECOS PAC ID: 7719010990 Enrollment ID: I20100809001082 |
| Provider Name | Mark Pinsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861485195 PECOS PAC ID: 7810047818 Enrollment ID: I20100929001554 |
| Provider Name | James D Kearney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447393244 PECOS PAC ID: 9537219530 Enrollment ID: I20100929001563 |
| Provider Name | Danny P Berk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871588749 PECOS PAC ID: 0749472553 Enrollment ID: I20101012001172 |
| Provider Name | Brian L Ireland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225275183 PECOS PAC ID: 2365620127 Enrollment ID: I20110624000542 |
| Provider Name | Dineshkumar Patel |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1316160161 PECOS PAC ID: 0648320713 Enrollment ID: I20120420000432 |
| Provider Name | Vikash Priyadarshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598995185 PECOS PAC ID: 5395991855 Enrollment ID: I20120816000112 |
| Provider Name | Robin W. Turinetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285973453 PECOS PAC ID: 2062657133 Enrollment ID: I20130320000070 |
| Provider Name | Holly Carter Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063757334 PECOS PAC ID: 6901042092 Enrollment ID: I20130416000181 |
| Provider Name | Rakesh Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720109598 PECOS PAC ID: 2961585419 Enrollment ID: I20130605000528 |
| Provider Name | Pavana Beerelli |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1891957031 PECOS PAC ID: 1759524762 Enrollment ID: I20130823000351 |
| Provider Name | Bhavesh Vekariya |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104166339 PECOS PAC ID: 7719121888 Enrollment ID: I20130912000211 |
| Provider Name | Brinda G Modh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851739304 PECOS PAC ID: 3779727300 Enrollment ID: I20130920000056 |
| Provider Name | Pratik A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114360831 PECOS PAC ID: 3476797978 Enrollment ID: I20130924000499 |
| Provider Name | Ervin Szoke |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1467485946 PECOS PAC ID: 1658362124 Enrollment ID: I20141010001017 |
| Provider Name | Raman Ashta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144496993 PECOS PAC ID: 5597818641 Enrollment ID: I20141023001852 |
| Provider Name | Thomas N Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730161548 PECOS PAC ID: 6305080060 Enrollment ID: I20141106001345 |
| Provider Name | Christopher Hutchinson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1487952016 PECOS PAC ID: 5890012215 Enrollment ID: I20150324002099 |
| Provider Name | Melissa Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487868782 PECOS PAC ID: 3678754173 Enrollment ID: I20151104000757 |
| Provider Name | Gaurang Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366739773 PECOS PAC ID: 9133353238 Enrollment ID: I20151106002324 |
| Provider Name | Pulkita Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982008397 PECOS PAC ID: 0547588998 Enrollment ID: I20160926000767 |
| Provider Name | Jharana Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003134370 PECOS PAC ID: 4789877226 Enrollment ID: I20170407001678 |
| Provider Name | Patricia A Goode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245267822 PECOS PAC ID: 6507125085 Enrollment ID: I20180108001566 |
| Provider Name | Jose Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104339662 PECOS PAC ID: 5496006009 Enrollment ID: I20180920002196 |
| Provider Name | Angela Jane Lis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245758978 PECOS PAC ID: 1254685332 Enrollment ID: I20181107002688 |
| Provider Name | Wendy Blagg Demko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780926378 PECOS PAC ID: 2163657073 Enrollment ID: I20190911003593 |
| Provider Name | Julie Totterdale Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477897692 PECOS PAC ID: 0648423574 Enrollment ID: I20200708002493 |
| Provider Name | Nirav Kishore Thakkar |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1144579327 PECOS PAC ID: 4981848926 Enrollment ID: I20210629003770 |
| Provider Name | Yadira Mishelle Augello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639843329 PECOS PAC ID: 2668879370 Enrollment ID: I20210923000236 |
| Provider Name | Allison Collings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194165423 PECOS PAC ID: 8426288804 Enrollment ID: I20220113000565 |
| Provider Name | Sarah Catherine Lynch Obradovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801236518 PECOS PAC ID: 1658764790 Enrollment ID: I20220212000157 |
| Provider Name | Kaitlyn Monique Michael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720710775 PECOS PAC ID: 7416337118 Enrollment ID: I20220711003621 |
| Provider Name | Ember-leigh Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740992361 PECOS PAC ID: 1759753205 Enrollment ID: I20230209000039 |
| Provider Name | Wendy Mae Dinapoli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457059024 PECOS PAC ID: 9931572286 Enrollment ID: I20230307001910 |
| Provider Name | Theresa Marie Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164119269 PECOS PAC ID: 4789049537 Enrollment ID: I20230429000121 |
| Provider Name | Bridgett Evette Williams-cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285129767 PECOS PAC ID: 7416136593 Enrollment ID: I20230822001578 |
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