SPACE COAST PATHOLOGISTS PA (NPI# 1750550232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750550232 |
| Entity Type | Organization |
| Organization Name | SPACE COAST PATHOLOGISTS PA |
| Practice Address |
13695 Us Highway 1 Sebastian FL 32958-3230 |
| Mailing Address |
Po Box 144333 Orlando FL 32814-4333 |
| Practice Telephone | 7725893186 |
| Practice Fax Number | 7725891022 |
| Mailing Telephone | 4074229831 |
| Mailing Fax Number | 4076482065 |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |
| Authorized Official Name | CARL T. SMEDBERG (PRESIDENT) |
| Authorized Official Telephone | 3219534804 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SPACE COAST PATHOLOGISTS PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | C15028 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700183506 | Space Coast Pathologists Pa | Clinical Medical Laboratory | 1350 S Hickory St, Melbourne, FL 32901-3224 | 2011-02-15 |
| 1184606188 | Space Coast Pathologists Pa | Pathology | 1350 S Hickory St, Dept. of Pathology, Melbourne, FL 32901-3278 | 2005-11-16 |
| Street Address |
13695 US HIGHWAY 1 |
| City | SEBASTIAN |
| State | FL |
| Zip Code | 32958-3230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730161993 | Sebastian River Anesthesiology Associates, P. A. | Specialist | 13695 Us Highway 1, Sebastian River Medical Center, Sebastian, FL 32958-3230 | 2005-11-15 |
| 1760013734 | Kelly Cleerdin Barrett | Dietitian, Registered | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2020-01-29 |
| 1336786029 | Steward Anesthesiology Physicians of Florida Inc. | Anesthesiology | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2019-12-02 |
| 1376199117 | Sebastian Pathology Services | Pathology | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2019-08-16 |
| 1750940532 | Capital Anesthesia Solutions of Florida, LLC | Nurse Anesthetist, Certified Registered | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2019-06-06 |
| 1275091647 | Brittany Robinson | Dietitian, Registered | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2019-03-05 |
| 1578035861 | Toni Shae Malloris | Nurse Practitioner | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2018-12-26 |
| 1619401528 | Steward Sebastian River Medical Center, Inc. | General Acute Care Hospital | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2017-04-18 |
| 1528592433 | Steward Sebastian River Medical Center, Inc. | Skilled Nursing Facility | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2017-04-18 |
| 1568825370 | Diane Jovanovich | Dietitian, Registered | 13695 Us Highway 1, Sebastian, FL 32958-3230 | 2016-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900714 | Maurice Vondell Wilson | Pharmacist | 7746 Bay Street, Sebastian, FL 32958 | 2020-10-22 |
| 1003426792 | Riverview Family Dental, Pa | Dentist | 1511 Us Highway 1, Suite 201, Sebastian, FL 32958 | 2020-08-06 |
| 1578102257 | Jessica Patrice Squiabro Pierce | Nurse Practitioner | 7765 144th St #4, Sebastian, FL 32958 | 2019-12-30 |
| 1952951949 | Renee Brothers | Occupational Therapist | Pelican Landing 13085 U.S. 1, Sebastian, FL 32958 | 2019-09-12 |
| 1457909681 | Tania M Schmitfranz | Physical Therapist | 1155 35h Lane, Suite 100, Vero Beach, FL 32958 | 2019-08-30 |
| 1255803649 | Christine A Festa | Family Medicine | 14060 Us Highway 1, Sebastian, FL 32958 | 2018-12-22 |
| 1639662174 | Wei Yin Vuong | Dentist | 1451 Sebastian Blvd Ste 180, Sebastian, FL 32958 | 2018-06-10 |
| 1194229724 | Courtney Carroll Frazier | Nurse Practitioner | 1627 Us Highway 1 Ste 207, Sebastian, FL 32958 | 2018-03-20 |
| 1386168771 | Main Street Counseling | Social Worker | 1069- Main Street, Ste 216, Sebastian, FL 32958 | 2017-07-28 |
| 1538516844 | Lynn Borlas | Speech-Language Pathologist | 1140 7th Court, Vero Beach, FL 32958 | 2016-05-17 |
| Find all providers in zip 32958 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780157321 | Richard Freij | Pathology | 9770 S Military Trl # B4-255, Boynton Beach, FL 33436-3207 | 2019-01-07 |
| 1447755137 | Brian Steven Mccarthy I | Pathology | 1719 Nw 23rd Ave Apt 1f, Gainesville, FL 32605-3005 | 2018-03-26 |
| 1841716123 | Kritika Krishnamurthy | Pathology | 4300 Alton Rd Ste 2400, Miami Beach, FL 33140-2948 | 2017-08-17 |
| 1982154167 | Johnny Paul Hughes | Pathology | 18317 Cypress Stand Cir, Tampa, FL 33647-1816 | 2016-10-11 |
| 1154870657 | Clinical Toxicology Pa | Pathology | 10269 Sw Village Pkwy, 102, Port Saint Lucie, FL 34987-2369 | 2016-09-25 |
| 1932584281 | Nichole Allen | Pathology | 2210 Marsh View Dr Unit 104, Wesley Chapel, FL 33544-4712 | 2015-07-29 |
| 1710368501 | Archi Patel | Pathology | 18311 Highwoods Preserve Pkwy Unit 6413, Tampa, FL 33647-1925 | 2015-06-17 |
| 1265839377 | Hugo Keiji Kaneku Nagahama | Pathology | 1600 Nw 10th Ave Rm 8149, Miami, FL 33136-1015 | 2014-12-04 |
| 1508278532 | Daniel Sanchez | Pathology | 7000 Sw 62nd Ave Ste 601, South Miami, FL 33143 | 2014-05-26 |
| 1508277799 | Kyle White | Pathology | 7188 Estero Dr, Lake Worth, FL 33463-5600 | 2014-05-11 |
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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.