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General NPI Number Information
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NPI Number | 1922006956
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Entity Type | Organization
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Legal Business Name | CAPE CANAVERAL HOSPITAL, INC.
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 3566 N HARBOR CITY BLVD
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City | MELBOURNE
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State | FL
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Zip | 32935-5714
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Country | US
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Telephone | 321-434-5909
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Fax | 321-434-1928
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Provider Business Mailing Address
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Address Line | 3566 N HARBOR CITY BLVD
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City | MELBOURNE
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State | FL
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Zip | 32935-5714
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Country | US
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Telephone | 321-434-5909
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Fax | 321-434-1928
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Authorized Official
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Title or Position | EVP CFO
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Name | KRISTEN PULIO
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Credential |
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Telephone | 321-434-5651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA210320962
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License Number State | FL
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