MEDICARE: COAST FLORIDA P.A.

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	122300000X	Dentist

General Provider Information

NPI Number	:	1427624840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COAST FLORIDA P.A.

Provider Business Mailing Address
First Line	:	5706 BENJAMIN CENTER DR STE 103
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5262
Country	:	US
Telephone Number	:	813-288-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2437 ENTERPRISE RD
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-7964
Country	:	US
Telephone Number	:	386-774-8009
Fax Number	:	386-774-9732

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MELODY RIVERA
Credential	:
Telephone Number	:	813-350-7166

Provider Enumeration Date	:	05/27/2021
Last Update Date	:	05/27/2021

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1679176697 — RACHEL M HAMON
Practice Location Address:

2437 ENTERPRISE RD
ORANGE CITY, FL
32763-7964

Practice Phone: 386-774-8009
Practice Fax:

1497347546 — DR. DIPTIBEN SMART
Practice Location Address:

2413 ENTERPRISE RD
ORANGE CITY, FL
32763-7964

Practice Phone: 386-218-4993
Practice Fax: 386-218-4913

1538920038 — ADVANTAGE MEDICAL GROUP LLC
Practice Location Address:

2415 ENTERPRISE RD
ORANGE CITY, FL
32763-7964

Practice Phone: 407-930-1112
Practice Fax: 407-930-1114

1982583365 — DR. DANIEL VINCENT HICKMAN DMD
Practice Location Address:

2437 ENTERPRISE RD
ORANGE CITY, FL
32763-7964

Practice Phone: 386-774-8009
Practice Fax:

1366332744 — NAMI WESTERN NEVADA
Practice Location Address:

3094 RESEARCH WAY STE 61
CARSON CITY, NV
89706-7964

Practice Phone: 775-350-7977
Practice Fax:

Directions to “COAST FLORIDA P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.