| Space Coast Lymphedema Clinic Llc | |
|
7000 Spyglass Ct., Suite 120, Viera, FL 32940 | |
| (321) 241-6543 | |
| (321) 241-6513 |
| Full Name | Space Coast Lymphedema Clinic Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 7000 Spyglass Ct., Viera, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477959856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT14733 (Florida) | Primary |
| 225X00000X | Occupational Therapist | OT12356 (Florida) | Secondary |
| Provider Name | Bertha A Whaley |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093376055 PECOS PAC ID: 4486686037 Enrollment ID: I20050906000699 |
| Provider Name | Marcia Jeddrie |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285034868 PECOS PAC ID: 4082930847 Enrollment ID: I20150313001446 |
| Provider Name | Rosanne Bessenaire |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194125880 PECOS PAC ID: 8921324781 Enrollment ID: I20150402001884 |
| Provider Name | Alexandra L Marston |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053849968 PECOS PAC ID: 0244658912 Enrollment ID: I20200911001171 |
| Provider Name | Brandi Delcazal |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487319596 PECOS PAC ID: 1658762521 Enrollment ID: I20220104000150 |
| Provider Name | Regina L Wells |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245928514 PECOS PAC ID: 1052772654 Enrollment ID: I20230728003314 |
| Mailing Address | Practice Location Address |
|---|---|
| Space Coast Lymphedema Clinic Llc 7000 Spyglass Ct., Suite 120, Viera, FL 32940 Ph: (321) 241-6543 | Space Coast Lymphedema Clinic Llc 7000 Spyglass Ct., Suite 120, Viera, FL 32940 Ph: (321) 241-6543 |
Mrs. Tracey K Weber, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8055 Spyglass Hill Rd Ste 103, Viera, FL 32940 Phone: 321-241-6543 Fax: 321-241-6513 | |
Karin Colby Watson, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4813 Sauvignon Pl, Viera, FL 32955 Phone: 321-637-1081 | |
Mrs. Aniela Orr, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8055 Spyglass Hill Rd Ste 103, Viera, FL 32940 Phone: 321-241-6543 Fax: 321-241-6513 | |
Mrs. Karen Jancheson, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2900veterans Way, Va Outpatient Clinic, Viera, FL 32940 Phone: 321-637-3788 | |
Doris Gonzalez, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2900 Veterans Way, Viera, FL 32940 Phone: 321-637-3788 Fax: 321-637-3688 | |
Dove Rehabilitation Services Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8085 Spyglass Hill Rd, Viera, FL 32940 Phone: 321-253-6316 Fax: 321-253-6317 | |
Rosanne Bessenaire, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 7000 Spyglass Ct., Suite 120, Viera, FL 32940 Phone: 321-241-6543 Fax: 321-241-6513 |