Space Coast Medical Associates LLP

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

SPACE COAST MEDICAL ASSOCIATES LLP

Practice address

490 N Washington Ave
Titusville, FL 32796-2871

Phone

(311) 268-4200

NPI assigned

May 1, 2006

Last updated

Jul 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Levine, MD

Title

Managing Partner

Phone

(321) 454-9001

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rex L Gomez, M.D.

  • Gastroenterology Physician
  • Rockledge, FL
  • NPI 1891745147
  NPD (past)
• Douglas P Calvin, M.D.

  • Radiation Oncology Physician
  • Appleton, WI
  • NPI 1780677906
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1558329581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962871",
            "telephone_number": "311-268-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962871",
            "telephone_number": "311-268-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST MEDICAL ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "321-454-9001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6992550001",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253792300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253792307",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253792301",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253792304",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253792305",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253792303",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Titusville Medical Center Inc
• Southern Living of Titusville
• Sovereign Healthcare of Titusville, LLC (Royal Oaks Nursing & Rehab Center)
• Space Coast Assisted Living LLC
• Space Coast Health Centers Inc
• Space Coast Medical Center
• Space Coast Medical Consultants PLLC
• Space Coast Ophthalmology LLC
• Space Coast Pain Relief Inc.
• Space Coast Radiology Associates

• Hematology & Oncology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.