Organization Active NPI

University Center Medical LLC

Doing business as L3Harris Family Medical Center

  • Primary Care Clinic/Center
  • Melbourne, FL
National Provider Identifier
1174969703
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
UNIVERSITY CENTER MEDICAL LLC
Doing business as
L3Harris Family Medical Center
Practice address
1800 W Hibiscus Blvd Ste 101
Melbourne, FL 32901-2624
Phone
(321) 726-1600
Fax
(321) 726-1610
NPI assigned
May 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Julia Watt
Title
Clinic Manager
Phone
(321) 726-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X FL Primary

Addresses

Primary practice location

1800 W Hibiscus Blvd Ste 101
Melbourne, FL 32901-2624

Mailing address

1800 W Hibiscus Blvd Ste 101
Melbourne, FL 32901-2624
Phone (321) 726-1600

Other names 1

  • L3Harris Family Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL Melbourne Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130701000755 FL Part B Supplier - Clinic/Group Practice 3476793134 Receives reassigned benefits from 5 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1800 W Hibiscus Blvd
Ste 100
Melbourne, FL 32901
Phone (321) 676-3535

1800 W Hibiscus Blvd
Ste 106
Melbourne, FL 32901
Phone (321) 726-1600

1800 W Hibiscus Blvd
Ste 105
Melbourne, FL 32901

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1174969703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W HIBISCUS BLVD STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012624",
            "telephone_number": "321-726-1600",
            "fax_number": "321-726-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W HIBISCUS BLVD STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012624",
            "telephone_number": "321-726-1600",
            "fax_number": "321-726-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY CENTER MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "WATT",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "321-726-1600"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Melbourne",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1800 W Hibiscus Blvd",
            "address_2": "Suite 105",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329012629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "L3Harris Family Medical Center",
            "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 Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.