Island Family Health Llc | |
260 N Tropical Trl Ste 105 Merritt Island FL 32953-4800 | |
(321) 208-8258 | |
(321) 735-7186 |
Full Name | Island Family Health Llc |
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Speciality | Family Medicine |
Location | 260 N Tropical Trl Ste 105, Merritt Island, Florida |
Authorized Official Name and Position | Nikolaos Kanellopoulos (OWNER) |
Authorized Official Contact | 3212088258 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Island Family Health Llc 260 N Tropical Trl Ste 105 Merritt Island FL 32953-4800 Ph: (321) 208-8258 | Island Family Health Llc 260 N Tropical Trl Ste 105 Merritt Island FL 32953-4800 Ph: (321) 208-8258 |
NPI Number | 1568939478 |
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Provider Enumeration Date | 10/29/2018 |
Last Update Date | 08/26/2022 |
Medicare PECOS PAC ID | 9234473646 |
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Medicare Enrollment ID | O20181211002606 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568939478 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Nikolaos Kanellopoulos |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760611867 PECOS PAC ID: 3476700667 Enrollment ID: I20120822000783 |
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