Space Coast Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SPACE COAST PEDIATRICS LLC

Practice address

8045 Spyglass Hill Rd Ste 105
Viera, FL 32940-8567

Phone

(321) 467-1660

NPI assigned

Jun 5, 2024

Organization subpart

No

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

Authorized official

Name

Arleene Sepulveda, MD

Title

Pediatrician

Phone

(772) 269-1904

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1346081189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 SPYGLASS HILL RD STE 105",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408567",
            "telephone_number": "772-269-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 SPYGLASS HILL RD STE 105",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329408567",
            "telephone_number": "321-467-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "ARLEENE",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "772-269-1904",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770813552",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yale R Smith, MD
• Sonus-USA, Inc.
• Brandi Dawn Sosa
• Space Coast Endodontics, PLLC
• Space Coast Lymphedema Clinic LLC
• Robin Marie Speck
• Michael Stewart Spicer, MD
• Tammy Star, LMHC
• Anh Stein Stein, MD
• Kai-Wyn Annika Sterling, CPHT

• Pediatrics Physician in Viera, FL
• Providers in Viera, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.