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SPACE COAST DERMATOLOGY CLINIC, PLLC
NPI 1043423189
Clinic/Center in Merritt Island, FL

Active since May 07, 2007
695 CONE PARK CT, MERRITT ISLAND, FL 32952(321) 453-3360(321) 453-4586 Get Directions Write a Review

NPPES record last updated: November 18, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Space Coast Dermatology Clinic, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPACE COAST DERMATOLOGY CLINIC, PLLC (NPI 1043423189) is a healthcare organization registered as a clinic/center in Merritt Island, Florida and active in the NPI registry since May 2007. The organization lists James A Earhart, Partner, as its authorized official.

NPPES Registry Identity

NPI1043423189
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSPACE COAST DERMATOLOGY CLINIC, PLLC
Location Address695 CONE PARK CTMerritt Island, FL 32952-3755
Mailing Address695 Cone Park CtMerritt Island, FL 32952-3755 · (321) 453-3360 · Fax (321) 453-4586
Phone(321) 453-3360
Fax(321) 453-4586
Organization SubpartNo
Authorized OfficialJames A EarhartPartner · (321) 453-3360
Enumeration DateMay 7, 2007
Last NPPES UpdateNovember 18, 2010
✔ NPI 1043423189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
695 CONE PARK CT, Merritt Island, FL 32952
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Other Identifiers 1

Medicare ID-Type Unspecified00844FL · Space Coast Dermatology

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MORGAN JACKSON PA-C
Physician Assistant
695 CONE PARK CT
MERRITT ISLAND, FL 32952
Brevard County (321) 453-3360
CHRISTINE M COOKE P.A.-C
Physician Assistant
695 CONE PARK CT
MERRITT ISLAND, FL 32952
Brevard County (321) 453-3360
JANE C MAST P.A.-C
Physician Assistant
695 CONE PARK CT
MERRITT ISLAND, FL 32952
Brevard County (321) 453-3360
DR. JAMES A EARHART MD
Dermatology
695 CONE PARK CT
MERRITT ISLAND, FL 32952
Brevard County (321) 453-3360

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Space Coast Dermatology Clinic, PLLC's NPI number?

The NPI number for Space Coast Dermatology Clinic, PLLC is 1043423189. It was assigned to this organization in the NPPES registry on May 7, 2007.

Where is Space Coast Dermatology Clinic, PLLC located?

Space Coast Dermatology Clinic, PLLC is located at 695 Cone Park Ct, Merritt Island, FL 32952. The listed phone number is (321) 453-3360.

What is Space Coast Dermatology Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Space Coast Dermatology Clinic, PLLC was last updated on November 18, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.