Healthcare Provider Details

I. General information

NPI: 1740200211
Provider Name (Legal Business Name): COMPASSIONATE MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 36TH ST STE C
VERO BEACH FL
32960-4875
US

IV. Provider business mailing address

PO BOX 401
VERO BEACH FL
32961-0401
US

V. Phone/Fax

Practice location:
  • Phone: 772-217-4422
  • Fax: 772-217-4460
Mailing address:
  • Phone: 772-567-4336
  • Fax: 772-567-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS07348
License Number StateFL

VIII. Authorized Official

Name: MR. NICHOLAS A COPPOLA
Title or Position: OWNER
Credential: D.O.
Phone: 772-567-4336