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General NPI Number Information
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NPI Number | 1285740720
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Entity Type | Organization
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Legal Business Name | COASTAL ORTHOPEDICS & SPORTS MEDICINE OF SOUTHWEST FLORIDA PA
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 8000 SR 64 E
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City | BRADENTON
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State | FL
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Zip | 34212
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Country | US
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Telephone | 941-792-1404
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Fax | 941-761-0712
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Provider Business Mailing Address
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Address Line | 8000 STATE ROAD 64 E
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City | BRADENTON
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State | FL
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Zip | 34212-7703
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Country | US
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Telephone | 941-792-1404
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Fax | 941-761-0712
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Authorized Official
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Title or Position | CEO
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Name | MS. PAIGE LEMAY
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Credential |
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Telephone | 941-792-1404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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