| |
709 S Harbor City Blvd Ste 110 Melbourne FL 32901-1938 | |
(321) 499-4646 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 709 S Harbor City Blvd Ste 110, Melbourne, Florida |
Authorized Official Name and Position | John Stewart (CEO/CFO) |
Authorized Official Contact | 8137315143 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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709 S Harbor City Blvd Ste 110 Melbourne FL 32901-1938 Ph: (321) 499-4646 | 709 S Harbor City Blvd Ste 110 Melbourne FL 32901-1938 Ph: (321) 499-4646 |
NPI Number | 1851907828 |
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Provider Enumeration Date | 09/16/2020 |
Last Update Date | 09/25/2023 |
Medicare PECOS PAC ID | 9931516804 |
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Medicare Enrollment ID | O20220505000461 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851907828 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Dennis Jones |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1649332149 PECOS PAC ID: 7012973217 Enrollment ID: I20080925000511 |
Provider Name | Donald H Vliegenthart |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1003964222 PECOS PAC ID: 3678635083 Enrollment ID: I20081218000586 |
Provider Name | Robert E Kent |
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Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1730407917 PECOS PAC ID: 8224256847 Enrollment ID: I20140823000203 |
Provider Name | Melissa A Burgos-martir |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1821390584 PECOS PAC ID: 1658647755 Enrollment ID: I20171017002786 |
Provider Name | Rohan Raj Sarna |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1467945485 PECOS PAC ID: 6204187743 Enrollment ID: I20230823000690 |
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