Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME101399 | FL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME101399 | FL |
NPI | 1013091784 |
---|---|
Provider Name | Dr. Audrius J Bredikis |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32901-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 04/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0035855700 | (05) | FL |
AL190X | MEDICARE (01) | FL |