Space Coast Anesthesiology and Pain Medicine PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME80599 Issued in FL

Legal business name

SPACE COAST ANESTHESIOLOGY AND PAIN MEDICINE PLLC

Practice address

907 Preakness PL
Rockledge, FL 32955-6112

Phone

(321) 433-1166

Fax

(321) 433-1166

NPI assigned

Sep 11, 2015

Organization subpart

Yes

Parent organization

SPACE COAST ANESTHESIOLOGY AND PAIN MEDICINE PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Yale R Smith, M.D.

Title

President

Phone

(321) 433-1166

Specialties & licenses 1

Addresses

Part of

Space Coast Anes Pain Med

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1194193888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 PREAKNESS PL",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556112",
            "telephone_number": "321-433-1166",
            "fax_number": "321-433-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 PREAKNESS PL",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556112",
            "telephone_number": "321-433-1166",
            "fax_number": "321-433-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST ANESTHESIOLOGY AND PAIN MEDICINE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPACE COAST ANESTHESIOLOGY AND PAIN MEDICINE PLLC",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "YALE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-433-1166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME80599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.