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General NPI Number Information
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NPI Number | 1053128710
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Entity Type | Organization
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Legal Business Name | COASTAL INFUSION LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 110
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6461
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Country | US
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Telephone | 954-361-1000
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Fax | 954-361-8699
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Provider Business Mailing Address
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Address Line | 4331 N FEDERAL HWY STE 300
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-5252
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Country | US
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Telephone | 954-361-1000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS DEVELOPEMENT
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Name | NICOLE BEGUIRISTAIN
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Credential |
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Telephone | 786-394-3063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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