Space Coast Medicine is a medicare enrolled primary clinic (Internal Medicine) in Melbourne Beach, Florida. The current practice location for Space Coast Medicine is 310 Avenue A, Melbourne Beach, Florida. For appointments, you can reach them via phone at
(850) 544-0142. The mailing address for Space Coast Medicine is Po Box 510195, Melbourne Beach, Florida and phone number is () -.
Space Coast Medicine is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1245931419. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(850) 544-0142.
Primary Care Clinic Profile
| Full Name | Space Coast Medicine |
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| Speciality | Internal Medicine |
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| Location | 310 Avenue A, Melbourne Beach, Florida |
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| Authorized Official Name and Position | Anthony Herzog (MD) |
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| Authorized Official Contact | 8505440142 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Space Coast Medicine
Po Box 510195
Melbourne Beach
FL 32951-0195
Ph: () - | Space Coast Medicine
310 Avenue A
Melbourne Beach
FL 32951-2201
Ph: (850) 544-0142 |
NPI Details:
| NPI Number | 1245931419 |
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| Provider Enumeration Date | 03/15/2023 |
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| Last Update Date | 03/15/2023 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 4587020326 |
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| Medicare Enrollment ID | O20230519002037 |
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Medical Identifiers
Medical identifiers for Space Coast Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245931419 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Space Coast Medicine acts as a billing entity for following providers:
| Provider Name | Anthony Jay Herzog |
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| Provider Type | Practitioner - Internal Medicine |
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| Provider Identifiers | NPI Number: 1003255019
PECOS PAC ID: 4587969852
Enrollment ID: I20170718000372 |
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