Healthcare Provider Details

I. General information

NPI: 1902746357
Provider Name (Legal Business Name): COACHFLOW SOUTH MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 N BAY RD
MIAMI BEACH FL
33140-4260
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 786-983-6996
  • Fax:
Mailing address:
  • Phone: 727-496-4429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LESLY KERNISANT
Title or Position: PRESIDENT
Credential: MD
Phone: 786-983-6996