Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Space Coast Podiatry LLC

Organization Foot & Ankle Surgery Podiatrist · NPI 1740037597

Space Coast Podiatry LLC is a Foot & Ankle Surgery Podiatrist in Palm Bay, Florida. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6100 Minton Rd NW Ste 101
Palm Bay, FL 32907-1900
Phone: (321) 802-4075
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X

Record details

NPI number1740037597
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Vaughn — Ceo/Physician · (321) 802-4075
NPI enumeratedApril 30, 2024
Last updated in NPPESSeptember 9, 2024
Certification dateSeptember 9, 2024
Mailing address6100 Minton Rd Nw Ste 101, Palm Bay, FL 32907-1900

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