1. Home
  2. Directory
  3. Florida
  4. Cocoa
  5. Internal Medicine
  6. NPI Profile

SPACE COAST INTERNAL MEDICINE & GERIATRIC LLC
NPI 1649383720
Internal Medicine in Cocoa, FL

Active since August 16, 2006CLIA 10D0961657 · Waiver
990 PALM ST, COCOA, FL 32927(321) 639-4243(321) 639-4266 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Space Coast Internal Medicine & Geriatric Llc NPPES

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

SPACE COAST INTERNAL MEDICINE & GERIATRIC LLC (NPI 1649383720), doing business as Space Coast Internal Medicine, is a healthcare organization registered as an internal medicine in Cocoa, Florida and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through January 31, 2028 and lists David Romanello, Coo, as its authorized official.

NPPES Registry Identity

NPI1649383720
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSPACE COAST INTERNAL MEDICINE & GERIATRIC LLC
Location Address990 PALM STCocoa, FL 32927-5145
Mailing AddressPo Box 549Sharpes, FL 32959-0549 · (321) 639-4243 · Fax (321) 639-4266
Phone(321) 639-4243
Fax(321) 639-4266
Organization SubpartNo
Authorized OfficialDavid RomanelloCoo · (352) 459-3661
Enumeration DateAugust 16, 2006
Last NPPES UpdateDecember 8, 2025
NPPES CertifiedDecember 8, 2025
✔ NPI 1649383720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME72416
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
990 PALM ST, Cocoa, FL 32927
Open in Google Maps ↗

Other Names 2

Doing Business AsSpace Coast Internal Medicine
Other NameFaiaz M Rasul

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 10D0961657

Space Coast Internal Med & Geriatrics · Port Saint John, FL
Active · expires Jan 31, 2028
CLIA Number10D0961657
Laboratory TypePhysician Office
Certificate Effective DateFebruary 1, 2026
Certificate Expiration DateJanuary 31, 2028
Laboratory DirectorFaiaz M. Rasul
Laboratory Phone(321) 639-4243
Laboratory LocationSpace Coast Internal Med & Geriatrics990 Palm St, Port Saint John, FL 32927
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Internal Medicine & Geriatric LLC's NPI number?

The NPI number for Space Coast Internal Medicine & Geriatric LLC is 1649383720. It was assigned to this organization in the NPPES registry on August 16, 2006. The provider is doing business as Space Coast Internal Medicine. The provider is also known as Faiaz M Rasul.

Where is Space Coast Internal Medicine & Geriatric LLC located?

Space Coast Internal Medicine & Geriatric LLC is located at 990 Palm St, Cocoa, FL 32927. The listed phone number is (321) 639-4243.

What is Space Coast Internal Medicine & Geriatric LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Space Coast Internal Medicine & Geriatric LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0961657) is associated with this NPI, valid through January 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Space Coast Internal Medicine & Geriatric LLC was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.