Surfside Family Practice Llc

LBN: Surfside Family Practice Llc
Surfside Family Practice Llc is an health care organization with primary practice located at 3000 N Atlantic Ave Suite 108, Cocoa Beach FL 32931-5078. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Surfside Family Practice Llc can be contacted via phone (321) 799-2554, or through Earle, Harry Allen via phone (321) 799-2554.

Contact Information

Primary practice address
3000 N Atlantic Ave Suite 108 Cocoa Beach FL 32931-5078
Phone: (321) 799-2554
Fax: (321) 799-4750
Website:
Map and Directions
Authorized official contact:
Name: Earle, Harry Allen Doctor of Medicine (MD)
Phone: (321) 799-2554

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X ME00059920 Florida

Profile Details

NPI number 1780872705
LBN Legal business name Surfside Family Practice Llc
DBA Doing business as
Authorized official Earle, Harry Allen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2007
Last updated Apr 22nd, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780872705 NPPES
Florida MEDICAID 055552599
Florida Other AG997

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