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General NPI Number Information
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NPI Number | 1497238091
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Entity Type | Organization
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Legal Business Name | COASTAL VEIN AND VASCULAR SPECIALISTS, INC
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 3401 PGA BLVD STE 325
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2898
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Country | US
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Telephone | 718-974-9494
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 PGA BLVD STE 325
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2898
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Country | US
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Telephone | 561-295-4110
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. CHRISTOPHER WILLIAM BOYES
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Credential |
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Telephone | 561-295-4110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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