NPIMap

Organization Active NPI

Space Coast Health Care Services

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1144274358
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SPACE COAST HEALTH CARE SERVICES
Practice address
2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185
Phone
(321) 254-6218
Fax
(321) 254-6230
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Alan Shapiro, M.D.NPI 1932283249
Title
Chief Executive Officer
Phone
(321) 254-6218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185

Mailing address

2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185
Phone (321) 254-6218

National Provider Directory

National Provider Directory

Locations

2080 W Eau Gallie Blvd
Ste A
Melbourne, FL 32935
Phone (321) 254-6218

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144274358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353185",
            "telephone_number": "321-254-6218",
            "fax_number": "321-254-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353185",
            "telephone_number": "321-254-6218",
            "fax_number": "321-254-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "321-254-6218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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.

Verify at the official NPI Registry.