SPACE HEALTH LLC (NPI# 1487270831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487270831 |
Entity Type | Organization |
Organization Name | SPACE HEALTH LLC |
Practice Address |
3800 W Eau Gallie Blvd Ste 101 Melbourne FL 32934-3285 |
Mailing Address |
Po Box 24556 Jacksonville FL 32241-4556 |
Practice Telephone | 3213233618 |
Mailing Telephone | 7863701111 |
Enumeration Date | 2020-06-22 |
Last Update Date | 2020-06-22 |
Authorized Official Name | RAFAEL FOSS (OWNER) |
Authorized Official Telephone | 7863701111 |
Authorized Official Credential | DC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
3800 W EAU GALLIE BLVD STE 101 |
City | MELBOURNE |
State | FL |
Zip Code | 32934-3285 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104336577 | Peak Performance Medical | Nurse Practitioner | 3800 W Eau Gallie Blvd Ste 101, Melbourne, FL 32934-3285 | 2017-10-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013530419 | Ryan Thomas Kammerdener | Pharmacist | 3003 Bay Wind Ct, Melbourne, FL 32934 | 2020-05-20 |
1558833731 | Deborah J Gaffney | Specialist/Technologist | 3060 Kershaw Court, Melbourne, FL 32934 | 2018-12-27 |
1548703200 | Damaris Escarment | Counselor | 3550 W. Eau Gallie Blvd, Melbourne, FL 32934 | 2016-11-29 |
1447686324 | Sarai Escarment | Counselor | 3550 W Eau Gallie Blvd, Melbourne, FL 32934 | 2013-09-23 |
1871874974 | Felipe E. Dominguez, Md, Pa | Clinical Medical Laboratory | 3030 Venture Lane, Ste 108, Melbourne, FL 32934 | 2011-09-01 |
1376821637 | Christine Natasha Williams Kelly | Counselor | 4450 West Eau Gallie Blvd, Suite 200, Melbourne, FL 32934 | 2011-08-03 |
1912203316 | Sheryl Yatsko | Physical Therapy Assistant | 3303 Sarno Rd, Melbourne, FL 32934 | 2011-02-01 |
1255564191 | Joy Cheryl Mullen | Occupational Therapy Assistant | 1890 Whispering Oaks Cir, West Melbourne, FL 32934 | 2009-08-26 |
1619031531 | The Devereux Foundation | Case Management | 1591 Robert J Conlan Boulevard, Palm Bay, FL 32934 | 2006-12-22 |
1457456600 | Jo A Kologlu | Physical Therapist | 5025 Smithfield Rd, Melbourne, FL 32934 | 2006-09-13 |
Find all providers in zip 32934 |
Taxonomy Code | 2081P2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Physical Medicine & Rehabilitation |
Specialization | Pain Medicine |
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417277831 | Mary Catherine Elliott | Physical Medicine & Rehabilitation | 3613 Quail Ct, Melbourne, FL 32904-9517 | 2010-06-08 |
1780108787 | Meghan Ashley Simon | Physical Medicine & Rehabilitation | 205 E Nasa Blvd Ste 200, Melbourne, FL 32901-1954 | 2017-08-01 |
1336684182 | Florida Pain & Rehabilitation Institute Inc | Physical Medicine & Rehabilitation | 308 S Harbor City Blvd Ste A, Melbourne, FL 32901-1500 | 2017-01-04 |
1518135888 | Sherin Kamal Fetouh | Physical Medicine & Rehabilitation | 307 E New Haven Ave, Melbourne, FL 32901-4576 | 2008-02-20 |
1366463226 | Jay E. Olsson, D.o., P.a. | Physical Medicine & Rehabilitation | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-07-23 |
1023041001 | Loggerhead Medical LLC | Physical Medicine & Rehabilitation | 307 E New Haven Ave, Melbourne, FL 32901-4576 | 2006-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477161214 | Radius Medical Center LLC | Physical Medicine & Rehabilitation | 2425 E Commercial Blvd Ste 203, Fort Lauderdale, FL 33308-4062 | 2020-07-17 |
1912460874 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 5701 21st Ave W Ste 3, Bradenton, FL 34209-5605 | 2019-04-08 |
1508320342 | Grigory Pogrebinsky Md Pa | Physical Medicine & Rehabilitation | 12450 Tamiami Trl S Unit E, North Port, FL 34287-1473 | 2019-01-25 |
1235611815 | Peter Danger Molina | Physical Medicine & Rehabilitation | 1190 Nw 95th St Ste 200, Miami, FL 33150-2064 | 2018-08-30 |
1497246540 | Restore Medical Partners Pllc | Physical Medicine & Rehabilitation | 333 Tamiami Trl S Ste 101, Venice, FL 34285-2425 | 2018-05-24 |
1568952240 | South Florida Physical Medicine and Rehabilitation Center LLC | Physical Medicine & Rehabilitation | 1200 S Main St Ste 200, Belle Glade, FL 33430-7808 | 2018-05-17 |
1235641655 | Boca Pain Care, Inc | Physical Medicine & Rehabilitation | 851 Meadows Rd Ste 213, Boca Raton, FL 33486-2348 | 2017-10-25 |
1558870477 | Pain Control Solutions II LLC | Physical Medicine & Rehabilitation | 8323 Nw 12th Street, Suite 115, Miami, FL 33126 | 2017-09-22 |
1245759851 | Chelsea Hakeem | Physical Medicine & Rehabilitation | 8936 77th Terrace East, Suit 101, Lakewood Ranch, FL 34202 | 2017-09-14 |
1508384165 | Destiny Therapy Center Inc | Physical Medicine & Rehabilitation | 7480 Fairway Dr., Suite 101, Miami Lakes, FL 33014 | 2017-09-05 |
Find all providers with the same taxonomy |
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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.