COASTAL PLUS MEDICAL CENTER INC NPI 1407172018

NPI Information

COASTAL PLUS MEDICAL CENTER INC is a primary care clinic center in Jacksonville, FL. COASTAL PLUS MEDICAL CENTER INC NPI is 1407172018. The provider is registered as an organization entity type.

The provider's business location address is:

11761 BEACH BLVD
SUITE 8
JACKSONVILLE, FL
ZIP 32246-615
Phone: (904) 642-3304
Fax: (904) 642-8375

The provider's authorized official is Carmen D Riza .
The authorized official title is Owner and has the following contact phone number (904) 642-3304.

The CLIA number assigned to this NPI record is 10D2118273 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/8/2010 and was last updated on 12/16/2019.

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:

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