Coastal Family Practice LLC

NPI #1275552358 in Edgewater, Florida

Provider Information

NPI Number
1275552358
Entity Type
Organization
Organization Name
Coastal Family Practice LLC
Primary Specialty
Family Medicine
Enumeration Date
Jul 19, 2006
Last Updated
Nov 9, 2009

Practice Location

Address
1404 S RIDGEWOOD AVE
State
Florida
ZIP Code
32132-2720
Phone
(386) 426-8166

Authorized Official

Name
PAM LACEY
Title
PRACTICE MANAGER
Phone
(386) 761-6044

Specialties & Taxonomy Codes

Specialty
Family Medicine

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