Florida East Coast Health Services, LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

ARNP9202808 Issued in FL

Legal business name

FLORIDA EAST COAST HEALTH SERVICES, LLC

Practice address

101 E Florida Ave
Melbourne, FL 32901-8301

Phone

(321) 591-0100

NPI assigned

Jul 25, 2017

Organization subpart

No

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

Authorized official

Name

Shelina Paradis, ARNP

Title

Vice President of Operations

Phone

(321) 591-0100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500940800000",
    "number": "1407379142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7904 S HIGHWAY A1A",
            "city": "MELBOURNE BEACH",
            "state": "FL",
            "postal_code": "329513911",
            "telephone_number": "321-591-0100",
            "fax_number": "866-600-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E FLORIDA AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018301",
            "telephone_number": "321-591-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA EAST COAST HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A",
        "authorized_official_last_name": "PARADIS",
        "authorized_official_first_name": "SHELINA",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "321-591-0100",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9202808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.