Space Coast Medical, LLC

NPI #1376807511 in Barefoot Bay, Florida

Provider Information

NPI Number
1376807511
Entity Type
Organization
Organization Name
Space Coast Medical, LLC
Primary Specialty
Clinic/Center - Rehabilitation
Enumeration Date
Jul 3, 2012
Last Updated
Jul 28, 2015

Practice Location

Address
935 BAREFOOT BLVD
Address 2
BLDG 1 SUITE 2
State
Florida
ZIP Code
32976-7620
Phone
(321) 557-4667

Authorized Official

Name
JASON LAIL
Title
C.E.O.
Phone
(321) 557-4667

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Physical TherapyPhysical Therapy
General Practice
Clinic/Center - RehabilitationRehabilitation

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