Organization · Type 2 NPI

Space Coast Family Practice

Clinic/Center · Green Bay, WI

NPI number 1811099054 Active

Practice location

3067 Windland Dr
Green Bay, WI 54311-7574

Call (920) 544-5868 Map

Specialties and licenses

TaxonomyCodeLicense
Clinic/Center Primary 261Q00000XME88311 (FL)

Clinic/Center: 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).

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About NPI 1811099054

Space Coast Family Practice's National Provider Identifier is 1811099054, issued on Sep 1, 2006. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Green Bay, WI. The record was last updated on Aug 22, 2020.