NPIMap

Organization Active NPI

Melbourne Medical LLC

  • Primary Care Clinic/Center
  • Melbourne, FL
National Provider Identifier
1366835795
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MELBOURNE MEDICAL LLC
Practice address
1600 W Eau Gallie Blvd
Suite 102
Melbourne, FL 32935-4149
Phone
(321) 751-3862
Fax
(321) 751-3865
NPI assigned
Mar 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Mr. Bill Mercer
Title
Operation Manager
Phone
(321) 751-3862

Specialties & licenses 1

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

Addresses

Primary practice location

1600 W Eau Gallie Blvd
Suite 102
Melbourne, FL 32935-4149

Mailing address

1600 W Eau Gallie Blvd
Suite 102
Melbourne, FL 32935-4149
Phone (321) 751-3862

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1366835795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD",
            "address_2": "SUITE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354149",
            "telephone_number": "321-751-3862",
            "fax_number": "321-751-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD",
            "address_2": "SUITE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354149",
            "telephone_number": "321-751-3862",
            "fax_number": "321-751-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELBOURNE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "MERCER",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "OPERATION MANAGER",
        "authorized_official_telephone_number": "321-751-3862",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Mar 10, 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.