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COASTAL NEUROLOGY INC. NPI 1457358434


NPI Information

NPI: 1457358434
Provider Name: COASTAL NEUROLOGY, INC.

Doing Business As: COASTAL PAIN MGMT, NEUROLOGY & REHABILITATION

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 10D2059089

Address:
725 W GRANADA BLVD
SUITE 22
ORMOND BEACH, FL
ZIP 32174
Phone: (386) 788-2300
Get Directions

COASTAL NEUROLOGY, INC. is a neurology psychiatry neurology in Ormond Beach, FL. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. COASTAL NEUROLOGY, INC. NPI is 1457358434. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Coastal Pain Mgmt, Neurology & Rehabilitation.

The provider's business location address is:

725 W GRANADA BLVD
SUITE 22
ORMOND BEACH, FL
ZIP 32174
Phone: (386) 788-2300
Fax: (386) 944-6622

The provider's authorized official is Neil M Brown .
The authorized official title is Ceo and has the following contact phone number (386) 788-2300.

The CLIA number assigned to this NPI record is 10D2059089 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/5/2005 and was last updated on 3/24/2023.


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
1208VP0014XPain MedicineInterventional Pain MedicineME84820FLORIDANo
2363AM0700XPhysician AssistantMedicalPA1823FLORIDANo
32081P2900XPhysical Medicine & RehabilitationPain MedicineNo
42084N0400XPsychiatry & NeurologyNeurologyOS5774FLORIDAYes

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
1E60482OTHERFLORIDAINDIVIDUAL-BENEZETTE

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: 5/5/2024

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