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COASTAL ESTHETICS LLC NPI 1114572245


NPI Information

NPI: 1114572245
Provider Name: COASTAL ESTHETICS, LLC

Doing Business As: COASTLINE PRIMARY CARE

Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
602 W INDIAN RIVER BLVD STE 2
EDGEWATER, FL
ZIP 32132
Phone: (386) 957-4100
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COASTAL ESTHETICS, LLC is an adult medicine family medicine in Edgewater, FL. The provider is definition to come. COASTAL ESTHETICS, LLC NPI is 1114572245. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Coastline Primary Care.

The provider's business location address is:

602 W INDIAN RIVER BLVD STE 2
EDGEWATER, FL
ZIP 32132-500
Phone: (386) 957-4100
Fax: (386) 957-4104

The provider's authorized official is Carissa Peterson .
The authorized official title is Owner/aprn and has the following contact phone number (386) 314-7483.

The enumeration date for this NPI number is 8/6/2019 and was last updated on 12/1/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0505XFamily MedicineAdult MedicineYes

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: 11/14/2023

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