Unknown Individual – Psychiatry Physician, NPI 1164572640
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Bouganvillea Drive, Rockledge, Brevard County, Florida, 32955, United States
SUITE A
ROCKLEDGE, FL 32955
Phone: (321) 636-6884
Fax: (321) 636-6846
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32955)
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