MEDICARE: CITY OF SATELLITE BEACH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333300000X	Emergency Response System Companies	0510	FL

General Provider Information

NPI Number	:	1124422027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF SATELLITE BEACH

Provider Business Mailing Address
First Line	:	1390 S PATRICK DR
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-4380
Country	:	US
Telephone Number	:	321-773-4405
Fax Number	:

Provider Business Practice Location Address
First Line	:	1390 S PATRICK DR
Second Line	:
City	:	SATELLITE BEACH
State	:	FL
Zip	:	32937-4380
Country	:	US
Telephone Number	:	321-773-4405
Fax Number	:

Authorized Official
Title or Position	:	FIRE /EMS CHIEF
Name	:	DONALD HUGHES
Credential	:	PARAMEDIC
Telephone Number	:	321-773-4405

Provider Enumeration Date	:	10/21/2014
Last Update Date	:	10/21/2014

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Directions to “CITY OF SATELLITE BEACH ” Practice Location

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