Coast Florida P.a.

NPI #1457927865 in Lake Mary, Florida

Provider Information

NPI Number: 1457927865
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: 2500 W LAKE MARY BLVD STE 106
City: Lake Mary
State: Florida
ZIP Code: 32746-3501
Phone: (407) 328-6411

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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