NPIMap

Organization Active NPI

Careatc - City of Cocoa

  • Primary Care Clinic/Center
  • Cocoa, FL
National Provider Identifier
1790239119
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CAREATC - CITY OF COCOA
Practice address
128 Lemon St
Cocoa, FL 32922-7624
Phone
(918) 779-7416
Fax
(855) 383-3237
NPI assigned
Aug 15, 2016
Last updated
Aug 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Authorized official

Name
Keith Gucwa
Title
Director of Purchasing and Faciliti
Phone
(918) 779-7416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

128 Lemon St
Cocoa, FL 32922-7624

Mailing address

128 Lemon St
Cocoa, FL 32922-7624
Phone (918) 779-7416

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2085262Careatc Cocoa128 Lemon St, Cocoa, FL 32922Certificate of waiverOct 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Careatc - Caledonia118 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 11

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

128 Lemon St
Cocoa, FL 32922
Phone (918) 779-7400

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1790239119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LEMON ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227624",
            "telephone_number": "918-779-7416",
            "fax_number": "855-383-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LEMON ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227624",
            "telephone_number": "918-779-7416",
            "fax_number": "855-383-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREATC - CITY OF COCOA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "GUCWA",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "DIRECTOR OF PURCHASING AND FACILITI",
        "authorized_official_telephone_number": "918-779-7416"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.