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General NPI Number Information
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NPI Number | 1265417729
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Entity Type | Organization
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Legal Business Name | COASTAL EAR NOSE & THROAT PA
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 1050 W GRANADA BLVD SUITE 4
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City | ORMOND BEACH
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State | FL
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Zip | 32174-8154
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Country | US
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Telephone | 386-677-8808
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Fax | 386-677-9919
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Provider Business Mailing Address
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Address Line | 1050 W GRANADA BLVD SUITE 4
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City | ORMOND BEACH
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State | FL
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Zip | 32174-8154
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Country | US
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Telephone | 386-677-8808
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Fax | 386-677-9919
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL A MUNIER
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Credential | MD
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Telephone | 386-677-8808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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