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Contact Information

SPACE COAST LYMPHEDEMA CLINIC LLC
7000 SPYGLASS CT.
SUITE 120
VIERA, FL32940
 Phone: 321-241-6543
 Fax: 321-241-6513
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for SPACE COAST LYMPHEDEMA CLINIC LLC

NPI # 1477959856
LBN Legal business name SPACE COAST LYMPHEDEMA CLINIC LLC
Authorized official ROSANNE BESSENAIRE - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/12/2014
Last updated 04/25/2018 - About 8 years ago
Identifiers
FL License # OT12356
FL License # PT14733
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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