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General NPI Number Information
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NPI Number | 1811875826
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Entity Type | Organization
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Legal Business Name | COASTAL KINETICS LLC
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1864 72ND AVE NE
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4714
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Country | US
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Telephone | 832-671-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 701 77TH AVE N UNIT 55042
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-5299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | ALEXANDER LAM
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Credential | DPT
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Telephone | 727-318-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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