Healthcare Provider Details

I. General information

NPI: 1740106772
Provider Name (Legal Business Name): COASTAL LIFE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42881 LAKE BABCOCK DR STE 200-C
PUNTA GORDA FL
33982-5041
US

IV. Provider business mailing address

42881 LAKE BABCOCK DR STE 200-C
PUNTA GORDA FL
33982-5041
US

V. Phone/Fax

Practice location:
  • Phone: 813-524-7176
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: YOCHONON TWERSKY
Title or Position: OWNER
Credential:
Phone: 718-749-3222