MEDICARE: WEST COAST MEDICAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP3213962	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP3213962	OTHER	FL	STATE OF FLORIDA LICENSE NUMBHER

General Provider Information

NPI Number	:	1366980641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST COAST MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	5824 STATE ROAD 54
Second Line	:	SUITE 100
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-6002
Country	:	US
Telephone Number	:	727-845-1933
Fax Number	:	727-845-7307

Provider Business Practice Location Address
First Line	:	5824 STATE ROAD 54
Second Line	:	SUITE 100
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-6002
Country	:	US
Telephone Number	:	727-845-1933
Fax Number	:	727-845-7307

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	JUNE E BAXTER
Credential	:
Telephone Number	:	727-845-1933

Provider Enumeration Date	:	02/07/2017
Last Update Date	:	02/07/2017

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Directions to “WEST COAST MEDICAL ASSOCIATES ” Practice Location

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