Surfside Family Practice Llc | |
3000 N Atlantic Ave Suite 108 Cocoa Beach FL 32931-5078 | |
(321) 799-2554 | |
(321) 799-4750 |
Full Name | Surfside Family Practice Llc |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 3000 N Atlantic Ave, Cocoa Beach, Florida |
Authorized Official Name and Position | Harry Allen Earle (DOCTOR) |
Authorized Official Contact | 3217992554 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Surfside Family Practice Llc 3000 N Atlantic Ave Suite 108 Cocoa Beach FL 32931-5078 Ph: (321) 799-2554 | Surfside Family Practice Llc 3000 N Atlantic Ave Suite 108 Cocoa Beach FL 32931-5078 Ph: (321) 799-2554 |
NPI Number | 1780872705 |
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Provider Enumeration Date | 10/04/2007 |
Last Update Date | 04/22/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780872705 | NPI | - | NPPES |
055552599 | Medicaid | FL | |
AG997 | Other | FL | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | ME00059920 (Florida) | Primary |
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Vincent P Marino Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 W Cocoa Beach Cswy, Cocoa Beach, FL 32931 Phone: 321-868-7170 Fax: 321-868-7159 | |
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