Coast Florida P.a. | |
1229 Providence Blvd Ste B Deltona FL 32725-7362 | |
(386) 574-8388 | |
(386) 574-0495 |
Full Name | Coast Florida P.a. |
---|---|
Speciality | Dentist |
Location | 1229 Providence Blvd Ste B, Deltona, Florida |
Authorized Official Name and Position | Melody Rivera (CREDENTIALING MANAGER) |
Authorized Official Contact | 8133507166 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Coast Florida P.a. 5706 Benjamin Center Dr Ste 103 Tampa FL 33634-5262 Ph: (813) 288-1999 | Coast Florida P.a. 1229 Providence Blvd Ste B Deltona FL 32725-7362 Ph: (386) 574-8388 |
NPI Number | 1407422884 |
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Provider Enumeration Date | 05/27/2021 |
Last Update Date | 05/27/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407422884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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