| Space Coast Medical Consultants Pllc | |
|
502 Garden St Titusville FL 32796-3405 | |
| (321) 621-0478 | |
| Not Available |
| Full Name | Space Coast Medical Consultants Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 502 Garden St, Titusville, Florida |
| Authorized Official Name and Position | Gaurav Mathur (CEO) |
| Authorized Official Contact | 3216210478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Space Coast Medical Consultants Pllc 502 Garden St Titusville FL 32796-3405 Ph: (321) 621-0478 | Space Coast Medical Consultants Pllc 502 Garden St Titusville FL 32796-3405 Ph: (321) 621-0478 |
| NPI Number | 1285429571 |
|---|---|
| Provider Enumeration Date | 04/09/2025 |
| Last Update Date | 04/09/2025 |
| Medicare PECOS PAC ID | 2163932054 |
|---|---|
| Medicare Enrollment ID | O20250610002002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285429571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
| Provider Name | Gaurav Narayan Mathur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588152367 PECOS PAC ID: 7214300748 Enrollment ID: I20230303002214 |
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