Space Coast Lymphedema Clinic LLC

NPI #1477959856 in Viera, Florida

Provider Information

NPI Number: 1477959856
Entity Type: Organization
Organization Name: Space Coast Lymphedema Clinic LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 12, 2014
Last Updated: Apr 25, 2018

Practice Location

Address: 7000 SPYGLASS CT.
Address 2: SUITE 120
City: Viera
State: Florida
ZIP Code: 32940
Phone: (321) 241-6543

Authorized Official

Name: MRS. ROSANNE BESSENAIRE, PT
Title: CEO
Phone: (321) 241-6543

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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