| Project Response, Inc. | |
|
747 S. Apollo Boulevard Melbourne FL 32901 | |
| (321) 372-5003 | |
| (321) 345-5671 |
| Full Name | Project Response, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 747 S. Apollo Boulevard, Melbourne, Florida |
| Authorized Official Name and Position | Christine Ann Hackford (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3217241177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Response, Inc. 745 S. Apollo Boulevard Melbourne FL 32901 Ph: (321) 724-1177 | Project Response, Inc. 747 S. Apollo Boulevard Melbourne FL 32901 Ph: (321) 372-5003 |
| NPI Number | 1487188058 |
|---|---|
| Provider Enumeration Date | 04/20/2017 |
| Last Update Date | 03/28/2018 |
| Medicare PECOS PAC ID | 6901150259 |
|---|---|
| Medicare Enrollment ID | O20181126003233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487188058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Florida) | Secondary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Ana Marisol Conde Rosa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972674687 PECOS PAC ID: 1254403660 Enrollment ID: I20120712000579 |
| Provider Name | Aisha Thomas-st. Cyr |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1619153541 PECOS PAC ID: 6800912932 Enrollment ID: I20140124001484 |
| Provider Name | Barbara A Baute |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841643079 PECOS PAC ID: 1557642683 Enrollment ID: I20170104002098 |
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