Coast Florida P.a.

NPI #1407422884 in Deltona, Florida

Provider Information

NPI Number: 1407422884
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
Enumeration Date: May 27, 2021
Last Updated: May 27, 2021

Practice Location

Address: 1229 PROVIDENCE BLVD STE B
City: Deltona
State: Florida
ZIP Code: 32725-7362
Phone: (386) 574-8388

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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