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General NPI Number Information
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NPI Number | 1568576908
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Entity Type | Organization
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Legal Business Name | EAST COAST MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 1500 NW 10TH AVE SUITE 205
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City | BOCA RATON
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State | FL
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Zip | 33486-1312
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Country | US
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Telephone | 561-391-1085
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Fax | 561-391-1449
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Provider Business Mailing Address
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Address Line | 1500 NW 10TH AVE SUITE 205
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City | BOCA RATON
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State | FL
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Zip | 33486-1312
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Country | US
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Telephone | 561-391-1085
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Fax | 561-391-1449
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRYAN SHAUN VINIK
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Credential | M.D.
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Telephone | 561-391-1085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | FL
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