Space Coast Skin Solutions LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SPACE COAST SKIN SOLUTIONS LLC

Practice address

5839 Snook LN
Grant, FL 32949-2253

Phone

(321) 720-2101

NPI assigned

May 30, 2025

Organization subpart

No

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

Authorized official

Name

Elyse Huff, NPNPI 1093213688

Title

Owner

Phone

(321) 720-2101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Elyse Huff, FNP-C

  • Family Nurse Practitioner
  • Melbourne, FL
  • NPI 1093213688
  Medicare reassignment Care Compare group NPD Authorized official
• Boney K. McGone, APRN

  • Family Nurse Practitioner
  • Melbourne, FL
  • NPI 1154433597
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1891688685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5839 SNOOK LN",
            "city": "GRANT",
            "state": "FL",
            "postal_code": "329492253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 SNOOK LN",
            "city": "GRANT",
            "state": "FL",
            "postal_code": "329492253",
            "telephone_number": "321-720-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST SKIN SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "HUFF",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-720-2101",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lumpkin
• Lynn Rene Musselman, OTR
• Jorge Rafael Ortega
• Yessenia Ortega, NURSE
• Holiday Amber Slingsby, WHNP
• Therapy Direct Inc
• Diane M Walker, PSY.D.

• Nurse Practitioner in Grant, FL
• Providers in Grant, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.