OrganizationActive
Space Coast Cardiology Consultants
NPI 1225053176 · Cardiovascular Disease Physician · Port St John, FL
Provider details
- NPI number
- 1225053176
- Entity type
- Organization
- Primary specialty
- Cardiovascular Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Laurie Holland, Administrator(352) 362-4223
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7139 North Highway US # 1
Port St John, FL 32927-5094
Phone: (321) 635-8304
Fax: (321) 635-8252
Approximate (ZIP-level) locationGet directions
Mailing address
7139 North Highway US # 1
Port St John, FL 32927-5094
Registry dates
- Enumerated
- 2006-07-13
- Last updated
- 2025-04-07
- Certified
- 2025-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.