Healthcare Provider Details

I. General information

NPI: 1437362167
Provider Name (Legal Business Name): COASTAL SPINE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 66TH ST SUITE 302
PINELLAS PARK FL
33781-2168
US

IV. Provider business mailing address

7800 66TH ST SUITE 302
PINELLAS PARK FL
33781-2168
US

V. Phone/Fax

Practice location:
  • Phone: 727-548-4880
  • Fax:
Mailing address:
  • Phone: 727-548-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberME0054576
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9101640
License Number StateFL

VIII. Authorized Official

Name: DR. PAUL ZAK
Title or Position: OWNER
Credential: M.D.
Phone: 727-548-4880