| Coastal Shoreline Medical Group | |
|
12522 Rockrose Gln Lakewood Ranch FL 34202-2827 | |
| (813) 944-9365 | |
| Not Available |
| Full Name | Coastal Shoreline Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 12522 Rockrose Gln, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Kimberly L Borsheim (ADMINISTRATOR) |
| Authorized Official Contact | 8139449365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Shoreline Medical Group 12522 Rockrose Gln Lakewood Ranch FL 34202-2827 Ph: (813) 944-9365 | Coastal Shoreline Medical Group 12522 Rockrose Gln Lakewood Ranch FL 34202-2827 Ph: (813) 944-9365 |
| NPI Number | 1164398806 |
|---|---|
| Provider Enumeration Date | 10/10/2025 |
| Last Update Date | 10/10/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164398806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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