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NPI Code Detail

MEDICARE: COASTAL DIALYSIS CENTER, LLC

MEDICARE: COASTAL DIALYSIS CENTER, LLC
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588920870
Entity Type Code : Organization
Provider Name (Legal Business Name) : COASTAL DIALYSIS CENTER, LLC
Provider Business Mailing Address
First Line : 641 UNIVERSITY BLVD STE 209
Second Line :
City : JUPITER
State : FL
Zip : 33458-2794
Country : US
Telephone Number : 561-557-1704
Fax Number :
Provider Business Practice Location Address
First Line : 641 UNIVERSITY BLVD STE 209
Second Line :
City : JUPITER
State : FL
Zip : 33458-2794
Country : US
Telephone Number : 561-253-8121
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ABBAS RABIEI
Credential : MD
Telephone Number : 561-557-1704
Provider Enumeration Date : 04/11/2012
Last Update Date : 09/03/2025

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1083883565 — MRS. STEPHANIE CAWLEY ARNP
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Directions to “COASTAL DIALYSIS CENTER, LLC ” Practice Location

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