Space Coast Radiology Associates

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SPACE COAST RADIOLOGY ASSOCIATES

Practice address

951 N Washington Ave
Titusville, FL 32796-2163

Phone

(321) 268-6192

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Flynn, D. O.

Title

Vice President

Phone

(321) 268-6192

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 2

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

• George Michael Antaki, MD

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1962479964
  NPD (past)
• Jeffrey M Swalchick, M.D.

  • Diagnostic Radiology Physician
  • Melbourne, FL
  • NPI 1447223458
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1396794566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3148",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063148",
            "telephone_number": "855-206-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "321-268-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST RADIOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "321-268-6192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. O."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "00250",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056061802",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CK0840",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056061803",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056061800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056061801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Space Coast Medical Associates LLP
• Space Coast Medical Center
• Space Coast Medical Consultants PLLC
• Space Coast Ophthalmology LLC
• Space Coast Pain Relief Inc.
• Space Coast Urology, LLC
• Jan L. Spagnoli, DDS
• Specialized Transportation for Outpatient Services, Inc.
• Specialized Treatment, Education and Prevention Services, Inc.
• Speechwise Therapy LLC

• Diagnostic Radiology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.