| Coastal Primary Care | |
|
4995 S Us Highway 1 Fort Pierce FL 34982-7079 | |
| (772) 465-3225 | |
| (772) 465-7687 |
| Full Name | Coastal Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 4995 S Us Highway 1, Fort Pierce, Florida |
| Authorized Official Name and Position | Maureen A Zelinka (PRESIDENT) |
| Authorized Official Contact | 7724653225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Primary Care 4995 S Us Highway 1 Fort Pierce FL 34982-7079 Ph: (772) 465-3225 | Coastal Primary Care 4995 S Us Highway 1 Fort Pierce FL 34982-7079 Ph: (772) 465-3225 |
| NPI Number | 1740397686 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 01/18/2016 |
| Medicare PECOS PAC ID | 1355245036 |
|---|---|
| Medicare Enrollment ID | O20031124000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740397686 | NPI | - | NPPES |
| DA5932 | Other | FL | RAILROAD MEDICARE |
| 722870 | Other | FL | AETNA |
| 269257100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS6842 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME0052169 (Florida) | Primary |
| Provider Name | Maureen Zelinka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336119718 PECOS PAC ID: 4385548007 Enrollment ID: I20041103000925 |
| Provider Name | Peggy Brigance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184844409 PECOS PAC ID: 2062513245 Enrollment ID: I20160511000228 |
| Provider Name | Kathleen Anne Gribbon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316453244 PECOS PAC ID: 2163782293 Enrollment ID: I20180208002691 |
| Provider Name | Katherine N Willingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306315825 PECOS PAC ID: 8224366059 Enrollment ID: I20190819000547 |
| Provider Name | Rose Gina Mangones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386350007 PECOS PAC ID: 1951757657 Enrollment ID: I20231101002549 |
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