Brevard Orthopaedic Spine & Pain Clinic INC

NPI #1003100504 in Melbourne, Florida

Provider Information

NPI Number: 1003100504
Entity Type: Organization
Organization Name: Brevard Orthopaedic Spine & Pain Clinic INC
Subpart: Yes (part of a larger organization)
Parent Organization: BREVARD ORTHOPAEDIC SPINE & PAIN CLINIC INC
Primary Specialty: Physical Therapist
Enumeration Date: Jun 2, 2011
Last Updated: Jul 15, 2021

Practice Location

Address: 2222 S HARBOR CITY BLVD
Address 2: SUITE 530
City: Melbourne
State: Florida
ZIP Code: 32901-5594
Phone: (321) 723-7716

Authorized Official

Name: KATRINA LOPEZ
Title: CREDENTIALING
Phone: (321) 541-1537

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Massage Therapist	225700000X
Physical Therapist	225100000X	Primary

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