Space Coast Surgical Assisting LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

SPACE COAST SURGICAL ASSISTING LLC

Practice address

749 McDermott Ave
Melbourne, FL 32935-3038

Phone

(321) 890-2022

NPI assigned

Nov 11, 2014

Organization subpart

No

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

Authorized official

Name

Michael A Dancy, CSFA, CSTNPI 1760888283

Title

MGR

Phone

(321) 890-2022

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michael Dancy, CSFA, CST

  • Surgical Physician Assistant
  • Melbourne, FL
  • NPI 1760888283
  NPD (past) Authorized official

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415664000000",
    "number": "1922404441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 N WICKHAM RD STE 16-422",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358923",
            "telephone_number": "321-890-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 MCDERMOTT AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353038",
            "telephone_number": "321-890-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPACE COAST SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A",
        "authorized_official_last_name": "DANCY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "321-890-2022",
        "authorized_official_credential": "CSFA, CST"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; 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.