| Space Coast Psychiatry, Inc | |
|
503 N Orlando Ave Suite 201 Cocoa Beach FL 32931-3171 | |
| (321) 613-5595 | |
| Not Available |
| Full Name | Space Coast Psychiatry, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 503 N Orlando Ave, Cocoa Beach, Florida |
| Authorized Official Name and Position | Joseph F Llinas (PRESIDENT) |
| Authorized Official Contact | 3216135595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Space Coast Psychiatry, Inc 503 N Orlando Ave Suite 201 Cocoa Beach FL 32931-3171 Ph: (321) 613-5595 | Space Coast Psychiatry, Inc 503 N Orlando Ave Suite 201 Cocoa Beach FL 32931-3171 Ph: (321) 613-5595 |
| NPI Number | 1912316886 |
|---|---|
| Provider Enumeration Date | 08/05/2014 |
| Last Update Date | 08/05/2014 |
| Medicare PECOS PAC ID | 2860610490 |
|---|---|
| Medicare Enrollment ID | O20140823000239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912316886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW5028 (Florida) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | ME116732 (Florida) | Primary |
| Provider Name | Joseph Llinas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013962158 PECOS PAC ID: 5597902189 Enrollment ID: I20130801000902 |
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