Provider Demographics
NPI:1558807412
Name:NORTH BREVARD COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:NORTH BREVARD COUNTY HOSPITAL DISTRICT
Other - Org Name:PARRISH SENIOR CONSULTATION AND SOLUTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SITOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-268-6333
Mailing Address - Street 1:951 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2163
Mailing Address - Country:US
Mailing Address - Phone:321-268-6111
Mailing Address - Fax:321-268-0125
Practice Address - Street 1:805 CENTURY MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2100
Practice Address - Country:US
Practice Address - Phone:321-383-9393
Practice Address - Fax:321-385-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIU646AMedicare PIN