Healthcare Provider Details

I. General information

NPI: 1700483435
Provider Name (Legal Business Name): COASTAL CARE SVCS TPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 SW 75TH AVE STE 300A
MIAMI FL
33155-4468
US

IV. Provider business mailing address

5000 SW 75TH AVE STE 300A
MIAMI FL
33155-4468
US

V. Phone/Fax

Practice location:
  • Phone: 855-481-0505
  • Fax: 866-481-0606
Mailing address:
  • Phone: 855-481-0505
  • Fax: 855-481-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: YSEL M GARCIA
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 855-481-0505