Space Coast Neurosurgery PA
Neurological Surgery in Rockledge, FL. Organization (NPI-2).
NPI number1730452913
StatusActive
Last updated in NPPESMar 11, 2012
Details
- NPI
- 1730452913
- Entity type
- Organization (NPI-2)
- Legal business name
- Space Coast Neurosurgery PA
- Organization subpart
- No
- Enumeration date
- Feb 17, 2012
- Last updated
- Mar 11, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207T00000X | Neurological Surgery | – | – | Yes |
Practice location
111 Longwood AveRockledge, FL 32955-2827
Phone 321-704-0828
Mailing address
111 Longwood AveRockledge, FL 32955-2827
Authorized official
Aaron Smith
President
3217040828
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