| Coastal Family Medicine Llc | |
|
1807 N Mckenzie St Foley AL 36535-2326 | |
| (251) 213-5824 | |
| Not Available |
| Full Name | Coastal Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1807 N Mckenzie St, Foley, Alabama |
| Authorized Official Name and Position | Nicole Manas Bodine (NURSE PRACTITIONER) |
| Authorized Official Contact | 2512135824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Family Medicine Llc 1807 N Mckenzie St Foley AL 36535-2326 Ph: (251) 215-4004 | Coastal Family Medicine Llc 1807 N Mckenzie St Foley AL 36535-2326 Ph: (251) 213-5824 |
| NPI Number | 1750911574 |
|---|---|
| Provider Enumeration Date | 01/21/2020 |
| Last Update Date | 05/31/2022 |
| Medicare PECOS PAC ID | 3375949035 |
|---|---|
| Medicare Enrollment ID | O20210903000137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750911574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lee E Eslava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639125602 PECOS PAC ID: 3274689526 Enrollment ID: I20090929000076 |
| Provider Name | Nicole M Bodine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780981159 PECOS PAC ID: 1850574120 Enrollment ID: I20110323000869 |
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