| Coastal Spine And Pain Center | |
|
280 Dundas Dr Jacksonville FL 32218-5517 | |
| (904) 282-6331 | |
| (904) 282-1550 |
| Full Name | Coastal Spine And Pain Center |
|---|---|
| Speciality | Pain Medicine |
| Location | 280 Dundas Dr, Jacksonville, Florida |
| Authorized Official Name and Position | Christopher Glenn (CFO) |
| Authorized Official Contact | 9042826331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Spine And Pain Center 705 Wells Rd Ste 300 Orange Park FL 32073-2982 Ph: (904) 282-6331 | Coastal Spine And Pain Center 280 Dundas Dr Jacksonville FL 32218-5517 Ph: (904) 282-6331 |
| NPI Number | 1174837504 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 06/27/2023 |
| Medicare PECOS PAC ID | 1254238579 |
|---|---|
| Medicare Enrollment ID | O20150403000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174837504 | NPI | - | NPPES |
| 259123500 | Medicaid | FL |
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