MEDICARE: PROJECT RESPONSE, INC.

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	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1487188058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROJECT RESPONSE, INC.

Provider Business Mailing Address
First Line	:	378 N BABCOCK ST STE B
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-7344
Country	:	US
Telephone Number	:	321-724-1177
Fax Number	:	321-724-2255

Provider Business Practice Location Address
First Line	:	378 N BABCOCK ST STE B
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32935-7344
Country	:	US
Telephone Number	:	321-724-1177
Fax Number	:	321-724-2255

Authorized Official
Title or Position	:	BILLING COORDINATOR
Name	:	JASMINE FRANKLIN
Credential	:
Telephone Number	:	321-724-1177

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	06/01/2026

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