| Space Coast Medical Management Llc | |
|
1840 Eldron Blvd Se Ste 2 Palm Bay FL 32909-6871 | |
| (561) 523-3973 | |
| Not Available |
| Full Name | Space Coast Medical Management Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1840 Eldron Blvd Se Ste 2, Palm Bay, Florida |
| Authorized Official Name and Position | Michael Husted (CFO) |
| Authorized Official Contact | 5615233973 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Space Coast Medical Management Llc 1840 Eldron Blvd Se Ste 2 Palm Bay FL 32909-6871 Ph: () - | Space Coast Medical Management Llc 1840 Eldron Blvd Se Ste 2 Palm Bay FL 32909-6871 Ph: (561) 523-3973 |
| NPI Number | 1881298768 |
|---|---|
| Provider Enumeration Date | 11/23/2020 |
| Last Update Date | 11/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881298768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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