# SPACE COAST OPHTHALMOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962954107
- **Authorized official:** NICHOLAS PEFKAROS MD (PRESIDENT)
- **Authorized official phone:** (321) 267-0008

## Contact information

- **Practice address:** 1832 GARDEN ST, TITUSVILLE, FL 32796-3200
- **Practice address phone:** (321) 433-2310
- **Mailing address:** 1832 GARDEN ST, TITUSVILLE, FL 32796-3200
- **Mailing address phone:** (321) 267-0008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2016
- **Last updated:** 03/13/2017