Healthcare Provider Details

I. General information

NPI: 1093652695
Provider Name (Legal Business Name): COASTAL KIDS ENDOCRINOLOGY AND WEIGHT MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GULF BREEZE PKWY STE 300
GULF BREEZE FL
32561-4458
US

IV. Provider business mailing address

400 GULF BREEZE PKWY STE 300
GULF BREEZE FL
32561-4458
US

V. Phone/Fax

Practice location:
  • Phone: 850-932-5055
  • Fax: 850-932-1404
Mailing address:
  • Phone: 850-932-5055
  • Fax: 850-932-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARTINA DRAWDY
Title or Position: PRESIDENT
Credential: MD
Phone: 802-735-3429