Coastline Medical Services Pllc | |
208 Mary Esther Blvd Mary Esther FL 32569-1687 | |
(908) 265-8949 | |
Not Available |
Full Name | Coastline Medical Services Pllc |
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Speciality | Clinic/Center |
Location | 208 Mary Esther Blvd, Mary Esther, Florida |
Authorized Official Name and Position | Michael Tavernaris (PHYSICIAN) |
Authorized Official Contact | 8503961110 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Coastline Medical Services Pllc 208 Mary Esther Blvd Mary Esther FL 32569-1687 Ph: () - | Coastline Medical Services Pllc 208 Mary Esther Blvd Mary Esther FL 32569-1687 Ph: (908) 265-8949 |
NPI Number | 1003361767 |
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Provider Enumeration Date | 08/23/2016 |
Last Update Date | 10/07/2019 |
Medicare PECOS PAC ID | 0143593392 |
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Medicare Enrollment ID | O20170909000031 |
Identifier | Type | State | Issuer |
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1003361767 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Secondary |
261QM2500X | Clinic/center - Medical Specialty | ME116308 (Florida) | Primary |
Provider Name | Michael E Tavernaris |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386888626 PECOS PAC ID: 2062654973 Enrollment ID: I20130806000172 |
Big Idea Chiropractic And Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 151 Mary Esther Blvd Ste 408, Mary Esther, FL 32569 Phone: 850-226-4440 |