Active NPI
Care Level Management Medical Group Florida, LLC
- General Practice Physician
- Melbourne, FL
National Provider Identifier
1063548287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- CARE LEVEL MANAGEMENT MEDICAL GROUP FLORIDA, LLC
- Doing business as
- Care Level Management
- Practice address
- 1958 Dairy Rd
Melbourne, FL 32904-4045 - Phone
- (800) 530-5441
- Fax
- (818) 595-8206
- NPI assigned
- Feb 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Richard St.Andrew
- Title
- Credentialing Coordinator
- Phone
- (800) 377-3606
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
1958 Dairy Rd
Melbourne, FL 32904-4045
Mailing address
5700 Canoga Ave
Suite 500
Woodland Hills, CA 91367-6579
Phone (800) 377-3606
Other names 1
- Care Level Management
National Provider Directory
National Provider DirectoryLocations
1958 Dairy Rd
Melbourne, FL 32904
Phone (321) 409-0010
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Melbourne, FL
- NPI 1861584609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1063548287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 CANOGA AVE",
"address_2": "SUITE 500",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913676579",
"telephone_number": "800-377-3606",
"fax_number": "818-595-8206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1958 DAIRY RD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329044045",
"telephone_number": "800-530-5441",
"fax_number": "818-595-8206"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARE LEVEL MANAGEMENT MEDICAL GROUP FLORIDA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ST.ANDREW",
"authorized_official_first_name": "RICHARD",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "800-377-3606"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Care Level Management",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.