| Brevard Health Alliance | |
|
705 Blake Ave Bldg G Cocoa FL 32922-7100 | |
| (321) 633-6391 | |
| (321) 633-6441 |
| Full Name | Brevard Health Alliance |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 705 Blake Ave, Cocoa, Florida |
| Authorized Official Name and Position | Angela Craig (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 3219529696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brevard Health Alliance 705 Blake Ave Bldg G Cocoa FL 32922-7100 Ph: (321) 633-6391 | Brevard Health Alliance 705 Blake Ave Bldg G Cocoa FL 32922-7100 Ph: (321) 633-6391 |
| NPI Number | 1104121300 |
|---|---|
| Provider Enumeration Date | 01/19/2011 |
| Last Update Date | 11/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104121300 | NPI | - | NPPES |
| 6886931-11 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Ana Conde Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Clearlake Rd Bldg K, Cocoa, FL 32922 Phone: 321-368-3862 | |
Ricardo Antonio Henriques M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 Delannoy Ave, Cocoa, FL 32922 Phone: 321-631-6995 Fax: 321-633-1004 | |
Steward Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1317 W Point Dr, Cocoa, FL 32922 Phone: 615-467-4158 Fax: 615-467-1267 | |
Brevard Health Alliance Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Pineda St, Cocoa, FL 32922 Phone: 321-241-6800 Fax: 321-241-6888 | |
Rameshwar N Mathur Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6250 N Us 1, Cocoa, FL 32927 Phone: 321-631-6402 Fax: 321-633-7041 | |
Shane C Hernesman Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 505 Delannoy Ave, Cocoa, FL 32922 Phone: 321-631-4940 Fax: 321-631-4941 |