Provider Demographics
NPI:1558456681
Name:BREVARD EYE CENTER, INC
Entity Type:Organization
Organization Name:BREVARD EYE CENTER, INC
Other - Org Name:PAUL J BEFANIS, MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRESPALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-984-3200
Mailing Address - Street 1:665 S APOLLO BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1485
Mailing Address - Country:US
Mailing Address - Phone:321-984-3200
Mailing Address - Fax:321-984-0032
Practice Address - Street 1:665 S APOLLO BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1485
Practice Address - Country:US
Practice Address - Phone:321-984-2346
Practice Address - Fax:321-984-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0539980003OtherDEMERC NC
FL086944900Medicaid
FL086944906Medicaid
FL086944907Medicaid
FL086944909Medicaid
1750322871OtherNPI HENDRIX
FLCK1407OtherMEDICARE ID TYPE UNSPECIFIED
0539980004OtherDEMERC ST
FL086944904Medicaid
FL086944908Medicaid
1275576712OtherNPI FISHER
1942346911OtherNPI REYNOLDS
FL24403OtherBCBS GROUP NUMBER
FL252338807Medicaid
FLCG1105OtherMEDICARE ID TYPE UNSPECIFIED
FL086944903Medicaid
1346288784OtherNPI BEFANIS
FL252338801Medicaid
FL252338802Medicaid
FL252338806Medicaid
00539980005OtherDEMERC PB
0539980006OtherDEMERC TV
FL086944905Medicaid
FL252338800Medicaid
FL252338803Medicaid
1003075730OtherNPI DELATORRE
1477503696OtherNPI TRES
FL252338805Medicaid
0539980002OtherDEMERC AP
FL086944902Medicaid
1518908607OtherNPI EHRET
1982622981OtherNPI RIEHL
FL252338804Medicaid
FL086944904Medicaid