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General NPI Number Information
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NPI Number | 1386677011
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Entity Type | Organization
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Legal Business Name | WEST COAST OB/GYN
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 513 MANATEE AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1145
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Country | US
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Telephone | 941-745-1616
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Fax | 941-748-1443
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Provider Business Mailing Address
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Address Line | 513 MANATEE AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1145
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Country | US
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Telephone | 941-745-1616
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Fax | 941-748-1443
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Authorized Official
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Title or Position | INSURANCE DEPARTMENT
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Name | MRS. CHARLOTTE D ELNAHWY
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Credential |
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Telephone | 941-745-1616
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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 | 0073879
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0040777
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License Number State | FL
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