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Organization
SPACE COAST MEDICAL CONSULTANTS PLLC
Active
Organization
SPACE COAST MEDICAL CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAURAV MATHUR MD (CEO)
(321) 621-0478
Entity
Organization
Contact information
Practice address
502 GARDEN ST, TITUSVILLE, FL 32796-3405
(321) 621-0478
Mailing address
502 GARDEN ST, TITUSVILLE, FL 32796-3405
(321) 621-0478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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