INDIAN RIVER MEDICAL OFFICE PA
NPI 1245220557
Specialist in Titusville, FL

Q: What is Indian River Medical Office PA's NPI number?

The NPI number for Indian River Medical Office PA is 1245220557. It was assigned to this organization in the NPPES registry on October 27, 2005.

Q: What is Indian River Medical Office PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since October 27, 2005CLIA 10D0919544 · Waiver

3300 DAIRY RD, TITUSVILLE, FL 32796(321) 269-6530(321) 269-2334 Get Directions Write a Review

NPPES record last updated: March 3, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Indian River Medical Office Pa NPPES

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

INDIAN RIVER MEDICAL OFFICE PA (NPI 1245220557) is a healthcare organization registered as a specialist in Titusville, Florida and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through April 1, 2028 and lists Jill D Whittamore, Administrator, as its authorized official.

NPPES Registry Identity

NPI1245220557

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameINDIAN RIVER MEDICAL OFFICE PA

Location Address3300 DAIRY RDTitusville, FL 32796-1512

Mailing Address3300 Dairy RdTitusville, FL 32796-1512 · (321) 269-6530 · Fax (321) 269-2334

Phone(321) 269-6530

Fax(321) 269-2334

Organization SubpartNo

Authorized OfficialJill D WhittamoreAdministrator · (321) 267-6687

Enumeration DateOctober 27, 2005

Last NPPES UpdateMarch 3, 2011

✔ NPI 1245220557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

3300 DAIRY RD, Titusville, FL 32796

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Other Identifiers 3

Other40745FL · Bcbs Fl

Medicare PIN40745FL

Medicaid250742100FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Wellpoint.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0919544

Indian River Medical Office PA · Titusville, FL

Active · expires Apr 1, 2028

CLIA Number10D0919544

Laboratory TypePhysician Office

Certificate Effective DateApril 2, 2026

Certificate Expiration DateApril 1, 2028

Laboratory DirectorAluino L. Ochoa

Laboratory Phone(321) 269-6530

Laboratory LocationIndian River Medical Office PA3300 Dairy Rd, Titusville, FL 32796

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

DEBRA ALLEN ARNP

Nurse Practitioner (Family)