Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brevard Wellness Clinc 1 LLC

Organization Internal Medicine Physician · NPI 1043633795

Brevard Wellness Clinc 1 LLC is an Internal Medicine Physician in Palm Bay, Florida. Licensed in Florida. Registered with an NPI since 2014.

Licensed in
FL
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1264 Malabar Rd SE
Palm Bay, FL 32907-2556
Phone: (321) 751-9506
Fax: (321) 751-9505
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence ME88036 (FL)

Record details

NPI number1043633795
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Srinivas Dontineni — President · (321) 751-9506
NPI enumeratedJanuary 31, 2014
Last updated in NPPESJanuary 31, 2014
Mailing address1264 Malabar Rd Se, Palm Bay, FL 32907-2556

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