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General NPI Number Information
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NPI Number | 1851950661
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Entity Type | Organization
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Legal Business Name | COASTAL CARE HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 8291 DANI DR STE 100
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City | FORT MYERS
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State | FL
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Zip | 33966-8021
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Country | US
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Telephone | 239-931-6049
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Fax | 239-931-4986
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Provider Business Mailing Address
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Address Line | 8291 DANI DR STE 101A
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City | FORT MYERS
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State | FL
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Zip | 33966-8009
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Country | US
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Telephone | 239-931-6049
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Fax | 239-931-4986
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Authorized Official
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Title or Position | OWNER AND AO
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Name | ANGELIA SAKYI-AGYEKUM
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Credential | PA
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Telephone | 904-437-1529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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