Space Coast Pathologists PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

SPACE COAST PATHOLOGISTS PA

Practice address

13695 US Highway 1
Sebastian, FL 32958-3230

Phone

(772) 589-3186

Fax

(772) 589-1022

NPI assigned

Feb 28, 2008

Organization subpart

Yes

Parent organization

SPACE COAST PATHOLOGISTS PAAs reported in NPPES

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

Authorized official

Name

Carl T. Smedberg, M.D.

Title

President

Phone

(321) 953-4804

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Pablo Enriquez MD

Locations

Practitioners 1

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

• Delia A. Smith, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Palm Bay, FL
  • NPI 1487636379
  NPD (past)

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1750550232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144333",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328144333",
            "telephone_number": "407-422-9831",
            "fax_number": "407-648-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13695 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583230",
            "telephone_number": "772-589-3186",
            "fax_number": "772-589-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST PATHOLOGISTS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPACE COAST PATHOLOGISTS PA",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "SMEDBERG",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-953-4804",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C15028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Sebastian, FL
• Providers in Sebastian, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.