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BREVARD WELLNESS CLINC 1 LLC
NPI 1043633795
Internal Medicine in Palm Bay, FL

Active since January 31, 2014
1264 MALABAR RD SE, PALM BAY, FL 32907(321) 751-9506(321) 751-9505 Get Directions Write a Review

NPPES record last updated: January 31, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brevard Wellness Clinc 1 Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREVARD WELLNESS CLINC 1 LLC (NPI 1043633795) is a healthcare organization registered as an internal medicine in Palm Bay, Florida and active in the NPI registry since January 2014. The organization lists Srinivas Rao Dontineni, President, as its authorized official.

NPPES Registry Identity

NPI1043633795
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBREVARD WELLNESS CLINC 1 LLC
Location Address1264 MALABAR RD SEPalm Bay, FL 32907-2556
Mailing Address1264 Malabar Rd SePalm Bay, FL 32907-2556 · (321) 751-9506 · Fax (321) 751-9505
Phone(321) 751-9506
Fax(321) 751-9505
Organization SubpartNo
Authorized OfficialSrinivas Rao DontineniPresident · (321) 751-9506
Enumeration DateJanuary 31, 2014
✔ NPI 1043633795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME88036
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1264 MALABAR RD SE, Palm Bay, FL 32907
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PENNY WALKER ARNP
Nurse Practitioner (Family)
1264 MALABAR RD SE
PALM BAY, FL 32907
Brevard County (321) 726-6464
DELIA A. SMITH M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
1264 MALABAR RD SE
PALM BAY, FL 32907
Brevard County (321) 434-1486
RITESH PATIL M.D.,MPH
Internal Medicine (Medical Oncology)
1264 MALABAR RD SE
PALM BAY, FL 32907
Brevard County (321) 434-8216

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brevard Wellness Clinc 1 LLC's NPI number?

The NPI number for Brevard Wellness Clinc 1 LLC is 1043633795. It was assigned to this organization in the NPPES registry on January 31, 2014.

Where is Brevard Wellness Clinc 1 LLC located?

Brevard Wellness Clinc 1 LLC is located at 1264 Malabar Rd SE, Palm Bay, FL 32907. The listed phone number is (321) 751-9506.

What is Brevard Wellness Clinc 1 LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Brevard Wellness Clinc 1 LLC was last updated on January 31, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.