| NPI | 1245220557 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2005-10-27 |
| Last Updated | 2011-03-03 |
| Authorized Official | Jill Whittamore ADMINISTRATOR Phone: 3212676687 |
| Mailing Address | 3300 Dairy Rd Titusville, FL 32796-1512 United States Phone: (321) 269-6530 | Fax: (321) 269-2334 📍 View Map |
| Primary Practice Address | 3300 Dairy Rd Titusville, FL 32796-1512 United States Phone: (321) 269-6530 | Fax: (321) 269-2334 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 250742100 | - |
| Other (non-Medicare) | FL | 40745 | BCBS FL |
| Other (non-Medicare) | FL | ========= | TAX ID |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 174400000X – Specialist | - | - |
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About NPI 1245220557
Indian River Medical Office Pa is an organization registered in the CMS NPPES NPI Registry with NPI number 1245220557. The primary specialty listed is Specialist. The organization is located in Titusville, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-10-27. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1245220557?
NPI 1245220557 belongs to Indian River Medical Office Pa, a Specialist in Titusville, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1245220557 active?
The current status of NPI 1245220557 in the NPPES registry is Active. The record was last updated on 2011-03-03.
What specialty is NPI 1245220557?
NPI 1245220557 is classified under the taxonomy Specialist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1245220557?
You can verify NPI 1245220557 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1245220557?
The primary practice address on file for NPI 1245220557 is 3300 Dairy Rd, Titusville, FL 32796-1512. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1245220557 issued?
NPI 1245220557 was first issued (enumerated) on 2005-10-27. The NPPES record was last updated on 2011-03-03.
Practice Location Map
Indian River Medical Office Pa is located at 3300 Dairy Rd, Titusville, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Indian River Medical Office Pa. All records sourced from the CMS NPPES registry.