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General NPI Number Information
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NPI Number | 1336076405
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Entity Type | Organization
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Legal Business Name | FIRST COAST FS, LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 10991 SAN JOSE BLVD STE 54
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City | JACKSONVILLE
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State | FL
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Zip | 32223-6655
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Country | US
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Telephone | 904-268-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 PLANTATION ISLAND DR S STE 204
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32080-3111
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Country | US
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Telephone | 904-794-1824
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Fax | 904-794-4584
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. STEPHEN STROUT
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Credential | DMD, MS, PA
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Telephone | 904-806-2037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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