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Contact Information

SPACECOASTPOP LLC
601 E STRAWBRIDGE AVE
MELBOURNE, FL32901-4733
 Phone: 321-301-0411
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optician

156FX1800X 96[5] Optician
 

Contact Lens Fitter

156FC0801X
Indicates primary specialty

NPI Profile & details for SPACECOASTPOP LLC

NPI # 1023807716
LBN Legal business name SPACECOASTPOP LLC
Authorized official ERICK ROSS - (PRESIDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/01/2025
Last updated 05/01/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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