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Organization

SPACECOASTPOP LLC

Active
Parent organization
SPACECOASTPOP LLC
Other names
Liberty Optical
Organization subpart
Yes

Provider details

NPI number
Legal business name
SPACECOASTPOP LLC
Authorized official
ERICK ROSS LICENSED OPTICIAN (PRESIDENT)
(321) 243-5255
Entity
Organization

Contact information

Practice address
601 E STRAWBRIDGE AVE, MELBOURNE, FL 32901-4733
(321) 301-0411
Mailing address
331 MELBOURNE AVE, INDIALANTIC, FL 32903-4315
(321) 243-5255
(321) 243-5255

Taxonomy

Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
156FX1800X
Optician
Primary

Other

Enumeration date
05/01/2025
Last updated
05/01/2025
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