Individual provider Active NPI

Jacqueline B Llinas, M.D.

  • Emergency Medicine Physician
  • Melbourne, FL
National Provider Identifier
1871604231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME68727 Issued in FL
Practice address
2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185
Phone
(321) 254-6218
Fax
(321) 254-6230
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME68727 FL Primary

Addresses

Primary practice location

2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185

Mailing address

2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185
Phone (321) 254-6218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041023000136 FL Practitioner - Emergency Medicine 8426019381 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME68727FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Physician Associates, PLLC Emergency Medicine CurrentSince Oct 1, 2013 Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients
Magnolia Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Brevard Emergency Services Emergency Medicine Past Accepting new patients
Space Coast Health Care Services Past Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients

Locations

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

Interoperability endpoints

  • Direct secure messaging: jllinas71688@epicdirect.hf.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871604231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353185",
            "telephone_number": "321-254-6218",
            "fax_number": "321-254-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353185",
            "telephone_number": "321-254-6218",
            "fax_number": "321-254-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLINAS",
        "first_name": "JACQUELINE",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME68727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.