SURFSIDE FAMILY PRACTICE LLC NPI 1780872705

NPI Information

  • NPI: 1780872705
  • Provider Name: SURFSIDE FAMILY PRACTICE LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 3000 N ATLANTIC AVE
    SUITE 108
    COCOA BEACH, FL
    ZIP 32931
  • Phone: (321) 799-2554

Map and Directions

Get Directions

NPI Details

SURFSIDE FAMILY PRACTICE LLC is a primary care clinic center in Cocoa Beach, FL. SURFSIDE FAMILY PRACTICE LLC NPI is 1780872705. The provider is registered as an organization entity type.

The provider's business location address is:

3000 N ATLANTIC AVE
SUITE 108
COCOA BEACH, FL
ZIP 32931-078
Phone: (321) 799-2554
Fax: (321) 799-4750

The provider's authorized official is Harry Allen Earle .
The authorized official title is Doctor and has the following contact phone number (321) 799-2554.

The enumeration date for this NPI number is 10/4/2007 and was last updated on 4/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareME00059920FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F14844MEDICARE UPINFLORIDA
2055552599MEDICAIDFLORIDA
3AG997OTHERFLORIDAMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI