INTRACOASTAL SURGERY CENTER, LLC (NPI# 1326527680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326527680 |
| Entity Type | Organization |
| Organization Name | INTRACOASTAL SURGERY CENTER, LLC |
| Practice Address |
2200 W Eau Gallie Blvd Ste 100 Melbourne FL 32935-3166 |
| Practice Telephone | 3217956095 |
| Mailing Telephone | 3217956095 |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2019-03-20 |
| Authorized Official Name | MR. JOHN WHEELER III (CLINICAL ADMINISTRATOR) |
| Authorized Official Telephone | 3216103460 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
2200 W EAU GALLIE BLVD STE 100 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669803391 | Surgery Center of Viera LLC | Clinic/Center | 7955 Spyglass Hill Rd Ste B, Melbourne, FL 32940-8249 | 2013-12-05 |
| 1558694034 | Brevard Specialty Surgery Center LLC | Clinic/Center | 95 Bulldog Boulevard, Suite 104, Melbourne, FL 32901-3175 | 2009-09-15 |
| 1306087135 | Crane Creek Surgical Partners, LLC | Clinic/Center | 2222 South Harbor City Blvd, Suite 540, Melbourne, FL 32901 | 2009-03-06 |
| 1164473922 | Ophthalmology Center of Brevard Lp | Clinic/Center | 719 E New Haven Ave, Melbourne, FL 32901-5459 | 2006-05-15 |
| 1558323956 | Melbourne Surgery Center Lp | Clinic/Center | 1340 Medical Park Dr, Suite 101, Melbourne, FL 32901-3246 | 2006-04-03 |
| 1174594584 | Sheridan Surgery Center | Clinic/Center | 95 Bulldog Blvd, Ste104, Melbourne, FL 32901-3332 | 2006-02-01 |
| 1255311635 | Melbourne Asc Lp | Clinic/Center | 1401 S Apollo Blvd, Suite B, Melbourne, FL 32901-3179 | 2006-01-20 |
| 1063495257 | Doctors Surgical Partnership Ltd | Clinic/Center | 1035 S Apollo Blvd, Melbourne, FL 32901-1969 | 2005-11-22 |
| 1013309459 | Melbourne Surgery Center, LLC | Clinic/Center | 95 Bulldog Blvd, Suite 104, Melbourne, FL 32901-3332 | 2015-02-23 |
| 1568644490 | Harbor City Surgical Care | Clinic/Center | 211 E New Haven Ave, Suite 1, Melbourne, FL 32901-4503 | 2007-12-03 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.