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General NPI Number Information
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NPI Number | 1891368783
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Entity Type | Organization
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Legal Business Name | COAST ANESTHESIA ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 914 MAR WALT DR STE A
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6706
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Country | US
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Telephone | 559-906-1390
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Fax | 850-807-5162
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Provider Business Mailing Address
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Address Line | 87 VISTA BLFS
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City | DESTIN
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State | FL
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Zip | 32541-4723
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Country | US
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Telephone | 559-906-1390
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN KRISTINE BARNETT
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Credential | MD
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Telephone | 559-906-1390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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