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BREVARD MEDICAL DERMATOLOGY, PA
NPI 1649676669
Dermatology in Melbourne, FL

Active since November 18, 2014CLIA 10D2120401 · Waiver
7960 N. WICKHAM ROAD, SUITE 103, MELBOURNE, FL 32940(321) 428-4737(321) 241-6457 Get Directions Write a Review

NPPES record last updated: February 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Brevard Medical Dermatology, Pa NPPES

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

BREVARD MEDICAL DERMATOLOGY, PA (NPI 1649676669) is a healthcare organization registered as a dermatology in Melbourne, Florida and active in the NPI registry since November 2014. The organization holds a CLIA Waiver certificate valid through October 16, 2026 and lists Michael Spicer, President, as its authorized official.

NPPES Registry Identity

NPI1649676669
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBREVARD MEDICAL DERMATOLOGY, PA
Location Address7960 N. WICKHAM ROAD, SUITE 103Melbourne, FL 32940-8096
Mailing Address7960 N. Wickham Road, Suite 103Melbourne, FL 32940-8096 · (321) 428-4737 · Fax (321) 241-6457
Phone(321) 428-4737
Fax(321) 241-6457
Organization SubpartNo
Authorized OfficialMichael SpicerPresident · (321) 428-4737
Enumeration DateNovember 18, 2014
Last NPPES UpdateFebruary 21, 2020
✔ NPI 1649676669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
7960 N. WICKHAM ROAD, Melbourne, FL 32940
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

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 10D2120401

Brevard Medical Dermatology PA · Melbourne, FL
Active · expires Oct 16, 2026
CLIA Number10D2120401
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2024
Certificate Expiration DateOctober 16, 2026
Laboratory DirectorMichael S. Spicer
Laboratory Phone(321) 428-4737
Laboratory LocationBrevard Medical Dermatology PA7960 N Wickham Road Suite 103, Melbourne, FL 32940
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.

MS. ANNA ELIZABETH WHITTINGTON PA-C
Physician Assistant (Medical)
7960 N. WICKHAM ROAD, SUITE 103
MELBOURNE, FL 32940
Brevard County (321) 428-4737

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 Medical Dermatology, PA's NPI number?

The NPI number for Brevard Medical Dermatology, PA is 1649676669. It was assigned to this organization in the NPPES registry on November 18, 2014.

Where is Brevard Medical Dermatology, PA located?

Brevard Medical Dermatology, PA is located at 7960 N. Wickham Road Suite 103, Melbourne, FL 32940. The listed phone number is (321) 428-4737.

What is Brevard Medical Dermatology, PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Brevard Medical Dermatology, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2120401) is associated with this NPI, valid through October 16, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Brevard Medical Dermatology, PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Brevard Medical Dermatology, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brevard Medical Dermatology, PA was last updated on February 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.