Healthcare Provider Details

I. General information

NPI: 1487571014
Provider Name (Legal Business Name): COASTAL SLEEP AND AIRWAY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 3RD ST
NEPTUNE BEACH FL
32266-5018
US

IV. Provider business mailing address

525 13TH AVE N
JACKSONVILLE BEACH FL
32250-4749
US

V. Phone/Fax

Practice location:
  • Phone: 850-814-2587
  • Fax:
Mailing address:
  • Phone: 850-814-2587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN HUMPHREYS
Title or Position: OWNER
Credential: DDS
Phone: 850-814-2587