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SPACE COAST OPHTHALMOLOGY LLC
NPI 1962954107
Ophthalmology in Titusville, FL

Active since November 03, 2016CLIA 10D2130000 · Waiver
1832 GARDEN ST, TITUSVILLE, FL 32796(321) 433-2310 Get Directions Write a Review

NPPES record last updated: March 13, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 13, 2017, Nov 8, 2016, Nov 3, 2016 (3 updates tracked since 2016).

About Space Coast Ophthalmology Llc NPPES

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

SPACE COAST OPHTHALMOLOGY LLC (NPI 1962954107) is a healthcare organization registered as an ophthalmology in Titusville, Florida and active in the NPI registry since November 2016. The organization holds a CLIA Waiver certificate valid through April 30, 2027 and lists Nicholas Pefkaros, President, as its authorized official.

NPPES Registry Identity

NPI1962954107
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameSPACE COAST OPHTHALMOLOGY LLC
Location Address1832 GARDEN STTitusville, FL 32796-3200
Mailing Address1832 Garden StTitusville, FL 32796-3200 · (321) 267-0008
Phone(321) 433-2310
Organization SubpartNo
Authorized OfficialNicholas PefkarosPresident · (321) 267-0008
Enumeration DateNovember 3, 2016
Last NPPES UpdateMarch 13, 20173 updates tracked since enumeration
✔ NPI 1962954107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1832 GARDEN ST, Titusville, FL 32796
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.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 10D2130000

Space Coast Ophthalmology · Titusville, FL
Active · expires Apr 30, 2027
CLIA Number10D2130000
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorNicholas A. Pefkaros
Laboratory Phone(321) 267-0008
Laboratory LocationSpace Coast Ophthalmology1832 Garden Street, 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 6

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

KAREN MENOR PA-C
Physician Assistant
1832 GARDEN ST, STE A
TITUSVILLE, FL 32796
Brevard County (321) 264-1961
CHRISTINE SPEER BUONO MD
Ophthalmology
1832 GARDEN ST
TITUSVILLE, FL 32796
Brevard County (321) 267-0008
DR. NICHOLAS ALEXANDER PEFKAROS M.D.
Ophthalmology
1832 GARDEN ST
TITUSVILLE, FL 32796
Brevard County (321) 267-0008
BREVARD PAIN MANAGEMENT, INC.
Anesthesiology (Pain Medicine)
1832 GARDEN ST
TITUSVILLE, FL 32796
Brevard County (321) 264-1961
MRS. KATHERINE MARIE VONNIEDERHAUSERN PAC
Anesthesiology (Pain Medicine)
1832 GARDEN ST
TITUSVILLE, FL 32796
Brevard County (321) 264-1961
SCO EYE SURGERY LLC
Clinic/Center (Ambulatory Surgical)
1832 GARDEN ST
TITUSVILLE, FL 32796
Brevard County (321) 267-0008

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 Ophthalmology LLC's NPI number?

The NPI number for Space Coast Ophthalmology LLC is 1962954107. It was assigned to this organization in the NPPES registry on November 3, 2016.

Where is Space Coast Ophthalmology LLC located?

Space Coast Ophthalmology LLC is located at 1832 Garden St, Titusville, FL 32796. The listed phone number is (321) 433-2310.

What is Space Coast Ophthalmology LLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Space Coast Ophthalmology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2130000) is associated with this NPI, valid through April 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Space Coast Ophthalmology LLC accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Space Coast Ophthalmology LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Space Coast Ophthalmology LLC was last updated on March 13, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.