MEDICARE: KRISTINE COATES ASSISTANCE AS NEEDED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	229349	FL

General Provider Information

NPI Number	:	1427036458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRISTINE COATES ASSISTANCE AS NEEDED

Provider Business Mailing Address
First Line	:	3923 LAKE WORTH RD
Second Line	:	SUIITE 101
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4049
Country	:	US
Telephone Number	:	561-439-4710
Fax Number	:	561-439-4750

Provider Business Practice Location Address
First Line	:	3923 LAKE WORTH RD
Second Line	:	SUIITE 101
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4049
Country	:	US
Telephone Number	:	561-439-4710
Fax Number	:	561-439-4750

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. KRISTINE KAREN COATES
Credential	:	R.N
Telephone Number	:	561-439-4710

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	08/22/2020

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