ETHOS HEALTH MELBOURNE LLC NPI 1942792429

NPI Information

NPI: 1942792429
Provider Name: ETHOS HEALTH MELBOURNE LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
2755 N WICKHAM RD STE 102
MELBOURNE, FL
ZIP 32935
Phone: (352) 732-5590
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ETHOS HEALTH MELBOURNE LLC is a multi-specialty clinic center in Melbourne, FL. ETHOS HEALTH MELBOURNE LLC NPI is 1942792429. The provider is registered as an organization entity type.

The provider's business location address is:

2755 N WICKHAM RD STE 102
MELBOURNE, FL
ZIP 32935-226
Phone: (352) 732-5590
Fax: (352) 732-0292

The provider's authorized official is Jonathan Walker .
The authorized official title is Owner/operator and has the following contact phone number (352) 732-5590.

The enumeration date for this NPI number is 5/31/2018 and was last updated on 5/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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