| Coastal Family Practice Llc | |
|
1404 S Ridgewood Ave Edgewater FL 32132-2720 | |
| (386) 426-8166 | |
| (386) 426-6399 |
| Full Name | Coastal Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1404 S Ridgewood Ave, Edgewater, Florida |
| Authorized Official Name and Position | Pam Lacey (PRACTICE MANAGER) |
| Authorized Official Contact | 3867616044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Family Practice Llc 1404 S Ridgewood Ave Edgewater FL 32132-2720 Ph: (386) 426-8166 | Coastal Family Practice Llc 1404 S Ridgewood Ave Edgewater FL 32132-2720 Ph: (386) 426-8166 |
| NPI Number | 1275552358 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 11/09/2009 |
| Medicare PECOS PAC ID | 1850486085 |
|---|---|
| Medicare Enrollment ID | O20071003000604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275552358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L800015935 (Florida) | Primary |
| Provider Name | Sandra L Buchanan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003923731 PECOS PAC ID: 8224040613 Enrollment ID: I20100817001501 |
| Provider Name | Margaret M Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205824778 PECOS PAC ID: 5698861227 Enrollment ID: I20101101000016 |
| Provider Name | Patricia J Fredette Huffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275521759 PECOS PAC ID: 5799871323 Enrollment ID: I20101101000074 |
Shores Medical Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 346 N Ridgewood Ave, Edgewater, FL 32132 Phone: 386-423-1888 Fax: 386-423-2030 | |
Coastline Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 109 W Knapp Ave, Edgewater, FL 32132 Phone: 386-957-4100 Fax: 386-957-4104 | |
Edgewater Internal Medicine Assoc. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2568 S. Ridgewood Ave, Suite 5, Edgewater, FL 32141 Phone: 386-428-4640 Fax: 386-426-1409 | |
Volusia Center For Surgical Excellence, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 N Ridgewood Ave, Edgewater, FL 32132 Phone: 386-424-1422 Fax: 386-424-1401 | |
Indian River Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2568 S Ridgewood Ave, Edgewater, FL 32141 Phone: 208-920-0932 |