Select Insurance Pros

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

License

A22023 Issued in FL

Legal business name

SELECT INSURANCE PROS

Practice address

23 Londonderry Dr
Palm Coast, FL 32137

Phone

(386) 864-3258

NPI assigned

Nov 6, 2013

Last updated

Nov 6, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Stephen J Ricke

Title

Owner

Phone

(386) 864-3258

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1053740365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LONDONDERRY DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321379716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 LONDONDERRY DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32137",
            "telephone_number": "386-864-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT INSURANCE PROS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "RICKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-864-3258",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "FL",
            "license": "A22023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.