Space Coast Family Practice

LBN: Space Coast Family Practice
Space Coast Family Practice is an health care organization with primary practice located at 3067 Windland Dr , Green Bay WI 54311-7574. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Space Coast Family Practice can be contacted via phone (920) 544-5868, or through Betka, Thomas Charles via phone (920) 544-5868.

Contact Information

Primary practice address
3067 Windland Dr Green Bay WI 54311-7574
Phone: (920) 544-5868
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Betka, Thomas Charles Doctor of Medicine (MD)
Phone: (920) 544-5868

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X ME88311 Florida

Profile Details

NPI number 1811099054
LBN Legal business name Space Coast Family Practice
DBA Doing business as
Authorized official Betka, Thomas Charles Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 1st, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers