Coast Florida P.a.

NPI #1396312096 in Melbourne, Florida

Provider Information

NPI Number: 1396312096
Entity Type: Organization
Organization Name: Coast Florida P.a.
Subpart: Yes (part of a larger organization)
Parent Organization: COAST FLORIDA P.A.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 10, 2021
Last Updated: Jun 10, 2021

Practice Location

Address: 7777 N WICKHAM RD STE 4
City: Melbourne
State: Florida
ZIP Code: 32940-7978
Phone: (321) 255-6303

Authorized Official

Name: MELODY RIVERA
Title: CREDENTIALING MANAGER
Phone: (813) 350-7166

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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