SPACE COAST EMERGENCY PHYSICIANS PLC (NPI# 1508851569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508851569 |
| Entity Type | Organization |
| Organization Name | SPACE COAST EMERGENCY PHYSICIANS PLC |
| Practice Address |
701 W Cocoa Beach Cswy Cocoa Beach FL 32931-3585 |
| Mailing Address |
Po Box 918994 Orlando FL 32891-8994 |
| Practice Telephone | 3217997111 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL MCGOOHAN (PRESIDENT) |
| Authorized Official Telephone | 8663966416 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS GROUP | 94825 | 01 |
| FL | RR MCR GROUP | DD1357 | 01 |
| Street Address |
701 W COCOA BEACH CSWY |
| City | COCOA BEACH |
| State | FL |
| Zip Code | 32931-3585 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487654729 | Mary Weaver | Nurse Practitioner | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2005-07-28 |
| 1821633603 | Jessica Chapon | Registered Nurse | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2019-11-15 |
| 1942844725 | Allison Leslie Westcott | Nurse Practitioner | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2019-11-04 |
| 1871055350 | Malia Flores | Hospitalist | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2019-04-03 |
| 1760909527 | Carlos David Walker | Pharmacist | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2017-08-23 |
| 1558773952 | Lillian Gonzales Sepulveda | Hospitalist | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2014-05-20 |
| 1336550284 | Craig Micheal Candle | Hospitalist | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2014-05-14 |
| 1699042465 | Rosanna Sanchez | Pharmacist | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2011-11-22 |
| 1124311964 | Brevard Pathology Pa | Pathology | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2011-05-26 |
| 1457687352 | Pramesh Patel | Hospitalist | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2009-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699275016 | Daniel Edgar Ferrier | Specialist/Technologist | 741 S Orlando Ave Apt B, Cocoa Beach, FL 32931 | 2018-02-13 |
| 1891206793 | Peace Club Inc. | Counselor | 1811 S. Orlando Avenue, Cocoa Beach, FL 32931 | 2017-10-18 |
| 1811384696 | Magnolia House Assisted Living Facility LLC | Assisted Living Facility | 103 Yacht Haven Drive, Cocoa Beach, FL 32931 | 2015-04-20 |
| 1801236807 | Muhammad Ishfaq | Internal Medicine | 701 W Cocoa Beach Causeway, Cocoa Beach, FL 32931 | 2013-07-05 |
| 1053658799 | Charles King | Pharmacist | 2067 North Atlantic Ave, Cocoa Beach, FL 32931 | 2013-01-15 |
| 1033464441 | Cori Megan Daniels | Nurse Practitioner | 1980 N. Atlantic Ave, Suite 627, Cocoa Beach, FL 32931 | 2012-07-23 |
| 1871850313 | Adel Tadros Fahmy | Obstetrics & Gynecology | 68 Country Club Road, Cocoa Beach, FL 32931 | 2012-04-23 |
| 1497021760 | Armstrong Chiropractic Family Center, Inc. | Clinic/Center | 1401 N. Atlantic Ave., Cocoa Beach, FL 32931 | 2012-03-30 |
| 1710261516 | Jill L Carey | Speech-Language Pathologist | 50 Country Club Rd, Cocoa Beach, FL 32931 | 2011-09-28 |
| 1700173416 | Barbara Greene | Registered Nurse | 26 West Point Drive, Cocoa Beach, FL 32931 | 2011-07-01 |
| Find all providers in zip 32931 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730631177 | Kerri Lynn Connell | Emergency Medicine | 275 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3529 | 2016-11-02 |
| 1770562803 | Preston Jones | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-17 |
| 1750361887 | Julio Perez | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-17 |
| 1770563819 | George Walker | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-17 |
| 1154300432 | Brandon Taival | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-13 |
| 1306825690 | Bangalore Ramakrishna | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-13 |
| 1386623676 | Michael Mcgoohan | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-13 |
| 1891774188 | Charles Manley Clodfelter Jr. | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-13 |
| 1245219542 | Maurice Chao | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-13 |
| 1043299340 | Leon Beeler | Emergency Medicine | 701 W Cocoa Beach Cswy, Cocoa Beach, FL 32931-3585 | 2006-01-13 |
| Find all providers in COCOA BEACH | ||||
| City | COCOA BEACH |
| Zip Code | 32931 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.