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General NPI Number Information
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NPI Number | 1265365340
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Entity Type | Organization
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Legal Business Name | COASTAL COMFORT HOME HEALTH AGENCY
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 1408 N KILLIAN DR, 208C
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City | LAKE PARK
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State | FL
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Zip | 33403
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Country | US
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Telephone | 561-662-2503
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 LAKE TERRY DR APT I
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-9287
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Country | US
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Telephone | 561-662-2503
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MR. XAVIER DEON BRYANT JR.
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Credential | RN
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Telephone | 561-662-2503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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