Organization Active NPI

Space Coast Lung & Sleep Center

  • Specialist
  • Merritt Island, FL
National Provider Identifier
1629438635
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SPACE COAST LUNG & SLEEP CENTER
Practice address
205 N Banana River Dr
Suite 105
Merritt Island, FL 32952-2596
Phone
(931) 212-8192
NPI assigned
Mar 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Mohamed Moataz Toban, M.D.
Title
Owner/Physician
Phone
(931) 212-8192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X FL Primary

Addresses

Primary practice location

205 N Banana River Dr
Suite 105
Merritt Island, FL 32952-2596

Mailing address

205 N Banana River Dr
Suite 105
Merritt Island, FL 32952-2596
Phone (931) 212-8192

National Provider Directory

National Provider Directory

Locations

205 N Banana River Dr
Ste 105
Merritt Island, FL 32952
Phone (321) 208-8361

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1629438635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N BANANA RIVER DR",
            "address_2": "SUITE 105",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329522596",
            "telephone_number": "931-212-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BANANA RIVER DR",
            "address_2": "SUITE 105",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329522596",
            "telephone_number": "931-212-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST LUNG & SLEEP CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "TOBAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "MOATAZ",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "931-212-8192",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.