Provider Demographics
NPI:1013091784
Name:BREDIKIS, AUDRIUS J (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDRIUS
Middle Name:J
Last Name:BREDIKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-361-5564
Mailing Address - Fax:
Practice Address - Street 1:1223 GATEWAY DR STE 2E
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-361-5564
Practice Address - Fax:321-956-2542
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101399207RC0000X, 207RC0001X, 207RC0000X
IL036-090600207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPP895OtherMEDICARE HF
FL0035855700Medicaid
FL0035855700Medicaid