Brevard Pathology PA
Brevard Pathology PA is a healthcare organization registered as Anatomic Pathology & Clinical Pathology Physician in Cocoa Beach, FL, holding Type 2 (organization) NPI 1124311964 since 2011. The authorized official on file is Marco Burenko, President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1124311964 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Brevard Pathology PA |
| Practice address | 701 W COCOA BEACH CSWY, Cocoa Beach, FL, 32931 |
| Phone | 3056662427 |
| Fax | 3056670239 |
| Enumeration date | 2011-05-26 |
| Last updated in NPPES | 2011-05-26 |
Authorized official
| Name | Marco Burenko |
|---|---|
| Title | President |
| Phone | 3056662427 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | Primary | ME 51687 | FL |
Copy-ready billing details
Provider: Brevard Pathology PA NPI: 1124311964 Taxonomy: 207ZP0102X (Anatomic Pathology & Clinical Pathology Physician) Address: 701 W COCOA BEACH CSWY, Cocoa Beach, FL, 32931
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1659379998 | Paul Hogg | Individual | Surgery Physician | Cocoa Beach, FL |
| 1487654729 | Mary Weaver | Individual | Gerontology Nurse Practitioner | Cocoa Beach, FL |
| 1508851569 | Space Coast Emergency Physicians Plc | Organization | Emergency Medicine Physician | Cocoa Beach, FL |
| 1114916640 | Faizal Rahaman | Individual | Hospitalist Physician | Cocoa Beach, FL |
| 1447234463 | Brian Boggs | Individual | Emergency Medicine Physician | Cocoa Beach, FL |
| 1154300432 | Brandon Taival | Individual | Emergency Medicine Physician | Cocoa Beach, FL |
| 1386623676 | Michael Mcgoohan | Individual | Emergency Medicine Physician | Cocoa Beach, FL |
| 1891774188 | Charles Clodfelter | Individual | Emergency Medicine Physician | Cocoa Beach, FL |
Verify this record
Cross-check NPI 1124311964 against the authoritative CMS record: view Brevard Pathology PA on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Brevard Pathology PA?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2011-05-26.