MEDICARE: COASTAL NEPHROLOGY & HYPERTENSION CENTER, PA

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	207RN0300X	Nephrology Physician	ME84437	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3766903	OTHER	FL	AETNA NON HMO
2	11127	OTHER	FL	BLUE CROSS
3	2087096	OTHER	FL	FIRST HEALTH CCN NETWORK
4	264835	OTHER	FL	AMERIGROUP INS
5	7239688	OTHER	FL	AETNA BLUE BELL
6	3354249	OTHER	FL	CIGNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	5885	OTHER	FL	AMERICAS HEALTH CHOICE
9	9308574	OTHER	FL	PHCS
10	H67857	OTHER	FL	VISTA HEALTH

General Provider Information

NPI Number	:	1881686608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL NEPHROLOGY & HYPERTENSION CENTER, PA

Provider Business Mailing Address
First Line	:	641 UNIVERSITY BLVD STE 211
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-2794
Country	:	US
Telephone Number	:	561-253-8121
Fax Number	:	561-253-8021

Provider Business Practice Location Address
First Line	:	641 UNIVERSITY BLVD STE 211
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-2794
Country	:	US
Telephone Number	:	561-253-8121
Fax Number	:	561-253-8021

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ABBAS RABIEI
Credential	:	MD
Telephone Number	:	561-253-8121

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	09/03/2025

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