ETHOS HEALTH MELBOURNE, LLC (NPI# 1942792429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942792429 |
| Entity Type | Organization |
| Organization Name | ETHOS HEALTH MELBOURNE, LLC |
| Practice Address |
2755 N Wickham Rd Ste 102 Melbourne FL 32935-2226 |
| Mailing Address |
1541 Se 17th St Ocala FL 34471-4607 |
| Practice Telephone | 3527325590 |
| Practice Fax Number | 3527320292 |
| Mailing Telephone | 3527325590 |
| Mailing Fax Number | 3527320292 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | JONATHAN WALKER (OWNER/OPERATOR) |
| Authorized Official Telephone | 3527325590 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
2755 N WICKHAM RD STE 102 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417585316 | Jennifer Lynn Waicus | Nurse Practitioner | 2755 N Wickham Rd Ste 102, Melbourne, FL 32935-2226 | 2020-03-28 |
| 1164081428 | Sharon Sinangote Haner | Physical Therapist | 2755 N Wickham Rd Ste 102, Melbourne, FL 32935-2226 | 2019-06-11 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696766 | Advanced Healthcare Integration, LLC | Clinic/Center | 445 Pineda Ct Ste 200, Melbourne, FL 32940-7555 | 2020-10-13 |
| 1639189251 | Medical Associates of Brevard LLC | Clinic/Center | 901 Jordan Blass Dr, Suite 103, Melbourne, FL 32940-1824 | 2006-08-08 |
| 1679582605 | Medical Associates of Brevard LLC | Clinic/Center | 580 N Wickham Rd, Suite A, Melbourne, FL 32935-8400 | 2006-08-07 |
| 1649896804 | Tricoche Integrated Health Inc | Clinic/Center | 1855 W Hibiscus Blvd, Melbourne, FL 32901-2622 | 2020-06-23 |
| 1487270831 | Space Health LLC | Clinic/Center | 3800 W Eau Gallie Blvd Ste 101, Melbourne, FL 32934-3285 | 2020-06-22 |
| 1659841914 | Biocellular Therapies Inc | Clinic/Center | 2290 W Eau Gallie Blvd Ste 210b, Melbourne, FL 32935-3145 | 2018-11-29 |
| 1992128508 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 110, Melbourne, FL 32935-3133 | 2014-02-03 |
| 1639592561 | Medical Associates of Brevard LLC | Clinic/Center | 575 S Wickham Rd, Suite A, Melbourne, FL 32904-1170 | 2014-01-29 |
| 1619104114 | Medical Associates of Brevard LLC | Clinic/Center | 2290 W Eau Gallie Blvd, Suite 202, Melbourne, FL 32935-3145 | 2009-06-11 |
| 1093940470 | Medical Associates of Brevard LLC | Clinic/Center | 1535 W Nasa Blvd, Bld C Suite 103, Melbourne, FL 32901-2635 | 2009-05-28 |
| 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.