# SPACE COAST PATHOLOGISTS PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPACE COAST PATHOLOGISTS PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750550232
- **Legal business name:** SPACE COAST PATHOLOGISTS PA
- **Authorized official:** CARL T. SMEDBERG M.D. (PRESIDENT)
- **Authorized official phone:** (321) 953-4804

## Contact information

- **Practice address:** 13695 US HIGHWAY 1, SEBASTIAN, FL 32958-3230
- **Practice address phone:** (772) 589-3186
- **Practice address fax:** (772) 589-1022
- **Mailing address:** PO BOX 144333, ORLANDO, FL 32814-4333
- **Mailing address phone:** (407) 422-9831
- **Mailing address fax:** (407) 648-2065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2008
- **Last updated:** 02/28/2008