Organization Active NPI

Space Coast Pathologists PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Sebastian, FL
National Provider Identifier
1750550232
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
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
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
SPACE COAST PATHOLOGISTS PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Carl T. Smedberg, M.D.NPI 1861474850
Title
President
Phone
(321) 953-4804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

13695 US Highway 1
Sebastian, FL 32958-3230

Mailing address

PO Box 144333
Orlando, FL 32814-4333
Phone (407) 422-9831

National Provider Directory

National Provider Directory
Part of
Space Coast Pathologists PA

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • 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.