Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Florida Institute of Technology

Organization Sports Medicine (Family Medicine) Physician · NPI 1336881572

Florida Institute of Technology provides Sports Medicine (Family Medicine) Physician services in Melbourne, Florida. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

150 W University Blvd
Melbourne, FL 32901-8995
Phone: (972) 367-4845
Show map & directions

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

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1336881572
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names Florida Tech Athletics
NPI enumeratedApril 8, 2022
Last updated in NPPESApril 8, 2022
Certification dateApril 8, 2022
Mailing address15305 Dallas Pkwy Ste 800, Addison, TX 75001-6415

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