Space Coast Discount Diabetic Supplies, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPACE COAST DISCOUNT DIABETIC SUPPLIES, INC.

Doing business as

Space Coast Diabetic Supplies

Practice address

3720 Curtis Blvd
Suite 104
Cocoa, FL 32927-3961

Phone

(321) 305-5908

Fax

(321) 305-5911

NPI assigned

Aug 27, 2007

Last updated

Mar 2, 2009By 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

Susan Veaudry

Title

President

Phone

(321) 305-5908

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Space Coast Diabetic Supplies Doing business as

Locations

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1740473354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 688",
            "city": "SHARPES",
            "state": "FL",
            "postal_code": "329590688",
            "telephone_number": "321-305-5908",
            "fax_number": "321-305-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 CURTIS BLVD",
            "address_2": "SUITE 104",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329273961",
            "telephone_number": "321-305-5908",
            "fax_number": "321-305-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST DISCOUNT DIABETIC SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "VEAUDRY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-305-5908"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF FLORIDA",
            "identifier": "R0049",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Space Coast Diabetic Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mikayla Solnosky
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• Carmen M Spector, PT
• Daylin Spence
• Carol Spencer, LCSW

• Durable Medical Equipment & Medical Supplies in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.