| Coastline Family Chiropractic Melbourne Llc | |
|
3980 Sarno Rd Suite 102 Melbourne FL 32934 | |
| (321) 610-3000 | |
| Not Available |
| Full Name | Coastline Family Chiropractic Melbourne Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 3980 Sarno Rd, Melbourne, Florida |
| Authorized Official Name and Position | Keith Ryan Hurley (AO) |
| Authorized Official Contact | 3216103000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastline Family Chiropractic Melbourne Llc 3980 Sarno Rd Suite 102 Melbourne FL 32934 Ph: (321) 610-3000 | Coastline Family Chiropractic Melbourne Llc 3980 Sarno Rd Suite 102 Melbourne FL 32934 Ph: (321) 610-3000 |
| NPI Number | 1912692567 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 04/10/2023 |
| Medicare PECOS PAC ID | 9335593474 |
|---|---|
| Medicare Enrollment ID | O20230925000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912692567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Keith Ryan Hurley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477188688 PECOS PAC ID: 4981024460 Enrollment ID: I20201022000868 |
| Provider Name | Abelsain Gonzalez Davila |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1942934005 PECOS PAC ID: 2264807221 Enrollment ID: I20230405002822 |
| Provider Name | Callerina Key |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558710046 PECOS PAC ID: 0244699825 Enrollment ID: I20230629001274 |
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