Project Response, Inc. | |
747 S. Apollo Boulevard Melbourne FL 32901 | |
(321) 372-5003 | |
(321) 345-5671 |
Full Name | Project Response, Inc. |
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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 |
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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 |
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Provider Enumeration Date | 04/20/2017 |
Last Update Date | 03/28/2018 |
Medicare PECOS PAC ID | 6901150259 |
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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 |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1972674687 PECOS PAC ID: 1254403660 Enrollment ID: I20120712000579 |
Provider Name | Aisha Thomas-st. Cyr |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1619153541 PECOS PAC ID: 6800912932 Enrollment ID: I20140124001484 |
Provider Name | Djenane Exceus |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851836753 PECOS PAC ID: 2466783899 Enrollment ID: I20191015003655 |
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