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General NPI Number Information
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NPI Number | 1215827837
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Entity Type | Organization
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Legal Business Name | COASTLINE THERAPY SERVICES
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 17706 CRESCENT MOON LOOP
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34211-1358
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Country | US
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Telephone | 678-428-0733
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Fax |
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Provider Business Mailing Address
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Address Line | 17706 CRESCENT MOON LOOP
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34211-1358
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Country | US
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Telephone | 678-428-0733
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHELSEA MIKLOS
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Credential | CCC-SLP
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Telephone | 678-428-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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