MEDICARE: COAST FLORIDA P.A.

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	122300000X	Dentist

General Provider Information

NPI Number	:	1801462213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COAST FLORIDA P.A.

Provider Business Mailing Address
First Line	:	5706 BENJAMIN CENTER DR STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5262
Country	:	US
Telephone Number	:	813-288-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 TAMPA RD STE 4
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-2291
Country	:	US
Telephone Number	:	727-787-0202
Fax Number	:	727-785-2374

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MELODY RIVERA
Credential	:
Telephone Number	:	813-350-7166

Provider Enumeration Date	:	05/27/2021
Last Update Date	:	05/27/2021

Similar Medicare Providers

1447856281 — CHRISTINA GEIER RDH
Practice Location Address:

3150 TAMPA RD STE 4
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Practice Phone: 727-787-0202
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1982555116 — VICTORIA ABA SOLUTION CORP
Practice Location Address:

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1457870065 — PREMISE HEALTH OF FLORIDA MEDICAL PA
Practice Location Address:

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1699772681 — JOEL IRA FRANCK MD.
Practice Location Address:

3180 CURLEW ROAD , SUITE 106
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1417956293 — HOWARD N CHIPMAN III M.D.
Practice Location Address:

3705 TAMPA RD , STE 22
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1497754014 — DR. AMANDA MAN WU M.D.
Practice Location Address:

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Directions to “COAST FLORIDA P.A. ” Practice Location

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