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NPI Code Detail

MEDICARE: COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA P.A.

MEDICARE: COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST 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
1224Z00000XOccupational Therapy Assistant
2225000000XOrthotic Fitter
32251H1200XHand Physical Therapist
42251S0007XSports Physical Therapist
52251X0800XOrthopedic Physical Therapist
6225200000XPhysical Therapy Assistant
7225700000XMassage Therapist
8225X00000XOccupational Therapist
9225XH1200XHand Occupational Therapist
10225100000XPhysical Therapist

General Provider Information

NPI Number : 1942361522
Entity Type Code : Organization
Provider Name (Legal Business Name) : COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA P.A.
Provider Business Mailing Address
First Line : 8000 STATE ROAD 64 E
Second Line :
City : BRADENTON
State : FL
Zip : 34212-7703
Country : US
Telephone Number : 941-792-1404
Fax Number : 941-794-1863
Provider Business Practice Location Address
First Line : 8000 STATE ROAD 64 E
Second Line :
City : BRADENTON
State : FL
Zip : 34212-7703
Country : US
Telephone Number : 941-792-1404
Fax Number : 941-794-1863
Authorized Official
Title or Position : CREDENTIALING SURPERVISOR
Name : NANCY R BORGGREN
Credential :
Telephone Number : 941-782-0102
Provider Enumeration Date : 12/13/2006
Last Update Date : 02/10/2025

Similar Medicare Providers

1053316448 — SCOTT M LAMB NP
Practice Location Address:
8000 SR 64 E
BRADENTON, FL
34212-7703
Practice Phone: 941-792-1404
Practice Fax: 941-761-0712
1205820347 — MR. ANTHONY PEVERINI CRNA
Practice Location Address:
8000 STATE ROAD 64 E # 205
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Practice Phone: 941-782-0101
Practice Fax:
1013977412 — MS. KIMBERLY G KRAFT PT CHT
Practice Location Address:
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BRADENTON, FL
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Practice Fax: 941-761-0712
1316981681 — LESLIE LOUISE TOSCANO PT
Practice Location Address:
8000 SR 64 E
BRADENTON, FL
34212-7703
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1932416120 — JASON R WOLF PA
Practice Location Address:
8000 STATE ROAD 64 E
BRADENTON, FL
34212-7703
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Practice Fax: 941-761-0712
1194134817 — JOSEPH MAGIONCALDA
Practice Location Address:
8000 STATE ROAD 64 E
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34212-7703
Practice Phone: 941-792-1404
Practice Fax: 941-761-0712

Directions to “COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA P.A. ” Practice Location

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