| Family Health Center At Port St John Llc | |
|
3740 Curtis Blvd Suite 108 Cocoa FL 32927-3962 | |
| (321) 633-5500 | |
| (321) 633-5566 |
| Full Name | Family Health Center At Port St John Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3740 Curtis Blvd, Cocoa, Florida |
| Authorized Official Name and Position | Janis G Black (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3216335500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center At Port St John Llc 3740 Curtis Blvd Suite 108 Cocoa FL 32927-3962 Ph: (321) 633-5500 | Family Health Center At Port St John Llc 3740 Curtis Blvd Suite 108 Cocoa FL 32927-3962 Ph: (321) 633-5500 |
| NPI Number | 1851575377 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 12/03/2013 |
| Medicare PECOS PAC ID | 2769559749 |
|---|---|
| Medicare Enrollment ID | O20080916000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851575377 | NPI | - | NPPES |
| 2753011400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS9694 (Florida) | Primary |
| Provider Name | Janis Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699721548 PECOS PAC ID: 7618973835 Enrollment ID: I20061011000647 |
| Provider Name | Olga D Emgushov |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003841222 PECOS PAC ID: 7416086533 Enrollment ID: I20100902000584 |
Ana Conde Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Clearlake Rd Bldg K, Cocoa, FL 32922 Phone: 321-368-3862 | |
Ricardo Antonio Henriques M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 Delannoy Ave, Cocoa, FL 32922 Phone: 321-631-6995 Fax: 321-633-1004 | |
Brevard Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 Blake Ave, Bldg G, Cocoa, FL 32922 Phone: 321-633-6391 Fax: 321-633-6441 | |
Steward Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1317 W Point Dr, Cocoa, FL 32922 Phone: 615-467-4158 Fax: 615-467-1267 | |
Brevard Health Alliance Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Pineda St, Cocoa, FL 32922 Phone: 321-241-6800 Fax: 321-241-6888 | |
Miracle Pain Relief Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 234 Willard St Ste C, Cocoa, FL 32922 Phone: 321-477-2273 | |
Rameshwar N Mathur Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6250 N Us 1, Cocoa, FL 32927 Phone: 321-631-6402 Fax: 321-633-7041 |