| Space Coast Ipa | |
|
95 Bulldog Blvd Suite 202 Melbourne FL 32901-3188 | |
| (321) 727-2990 | |
| (321) 724-0455 |
| Full Name | Space Coast Ipa |
|---|---|
| Speciality | General Practice |
| Location | 95 Bulldog Blvd, Melbourne, Florida |
| Authorized Official Name and Position | Craig K Deligdish (BOARD MEMBER) |
| Authorized Official Contact | 3217273495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Space Coast Ipa 95 Bulldog Blvd Suite 202 Melbourne FL 32901-3188 Ph: (321) 727-2990 | Space Coast Ipa 95 Bulldog Blvd Suite 202 Melbourne FL 32901-3188 Ph: (321) 727-2990 |
| NPI Number | 1134371933 |
|---|---|
| Provider Enumeration Date | 10/13/2008 |
| Last Update Date | 07/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134371933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
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