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PEDIATRIC HEALTH & WELLNESS OF BREVARD, PA
NPI 1629880711
Clinic/Center - Primary Care in Melbourne, FL

Active since January 24, 2025CLIA 10D2320381 · Waiver
3000 N WICKHAM RD STE 5, MELBOURNE, FL 32935(321) 652-2381 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pediatric Health & Wellness Of Brevard, Pa NPPES

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

PEDIATRIC HEALTH & WELLNESS OF BREVARD, PA (NPI 1629880711) is a healthcare organization registered as a primary care in Melbourne, Florida and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through March 17, 2027 and lists Kimberly M Martin, President, as its authorized official.

NPPES Registry Identity

NPI1629880711
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePEDIATRIC HEALTH & WELLNESS OF BREVARD, PA
Location Address3000 N WICKHAM RD STE 5Melbourne, FL 32935-2330
Mailing Address4355 Lakemont RdMelbourne, FL 32934-7731 · (321) 652-2381
Phone(321) 652-2381
Organization SubpartNo
Authorized OfficialKimberly M MartinPresident · (321) 652-2381
Enumeration DateJanuary 24, 2025
NPPES CertifiedJanuary 24, 2025
✔ NPI 1629880711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
3000 N WICKHAM RD STE 5, Melbourne, FL 32935
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2320381

Pediatric Health & Wellness Of Brevard, PA · Melbourne, FL
Active · expires Mar 17, 2027
CLIA Number10D2320381
Laboratory TypeNurse Practitoner Primary
Certificate Effective DateMarch 18, 2025
Certificate Expiration DateMarch 17, 2027
Laboratory DirectorKimberly Martin
Laboratory Phone(321) 652-2381
Laboratory LocationPediatric Health & Wellness Of Brevard, PA3000 N Wickham Rd Ste 5, Melbourne, FL 32935
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

MRS. KIMBERLY M MARTIN ARNP
Nurse Practitioner (Pediatrics)
3000 N WICKHAM RD STE 5
MELBOURNE, FL 32935
Brevard County (321) 345-1880

Frequently Asked Questions

What is PEDIATRIC HEALTH & WELLNESS OF BREVARD, PA's NPI number?

The NPI number assigned to this healthcare provider is 1629880711, enumerated as an "organization" on January 24, 2025.

Where is the provider located?

The provider is located at 3000 N WICKHAM RD STE 5 MELBOURNE, FL 32935 and the phone number is (321) 652-2381.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.