1. Home
  2. Directory
  3. Florida
  4. Barefoot Bay
  5. Clinic Center
  6. NPI Profile

SPACE COAST MEDICAL, LLC
NPI 1376807511
Clinic/Center - Rehabilitation in Barefoot Bay, FL

Active since July 03, 2012
935 BAREFOOT BLVD, BLDG 1 SUITE 2, BAREFOOT BAY, FL 32976(321) 557-4667 Get Directions Write a Review

NPPES record last updated: July 28, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Space Coast Medical, Llc NPPES

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

SPACE COAST MEDICAL, LLC (NPI 1376807511) is a healthcare organization registered as a rehabilitation in Barefoot Bay, Florida and active in the NPI registry since July 2012. The organization lists Jason Lail, C.e.o., as its authorized official.

NPPES Registry Identity

NPI1376807511
Entity TypeOrganization
Primary Taxonomy261QR0400X
Legal Business NameSPACE COAST MEDICAL, LLC
Location Address935 BAREFOOT BLVD, BLDG 1 SUITE 2Barefoot Bay, FL 32976-7620
Mailing Address4295 N Us Highway 1Melbourne, FL 32935-4822 · (321) 557-4667
Phone(321) 557-4667
Organization SubpartNo
Authorized OfficialJason LailC.e.o. · (321) 557-4667
Enumeration DateJuly 3, 2012
Last NPPES UpdateJuly 28, 2015
✔ NPI 1376807511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · RehabilitationAmbulatory Health Care Facilities
Taxonomy Code261QR0400X
Also ListedGeneral PracticeTaxonomy 208D00000X · License OS6898 (FL)
Also ListedClinic/Center · Physical TherapyTaxonomy 261QP2000X
935 BAREFOOT BLVD, Barefoot Bay, FL 32976
Open in Google Maps ↗

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 Medical, LLC's NPI number?

The NPI number for Space Coast Medical, LLC is 1376807511. It was assigned to this organization in the NPPES registry on July 3, 2012.

Where is Space Coast Medical, LLC located?

Space Coast Medical, LLC is located at 935 Barefoot Blvd Bldg 1 Suite 2, Barefoot Bay, FL 32976. The listed phone number is (321) 557-4667.

What is Space Coast Medical, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.

When was this NPI record last updated?

The NPPES record for Space Coast Medical, LLC was last updated on July 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.