| Coastal Healthcare Partners, Llc | |
|
50 Leanni Way Suite D1 Palm Coast FL 32137 | |
| (386) 283-5997 | |
| (386) 283-5652 |
| Full Name | Coastal Healthcare Partners, Llc |
|---|---|
| Speciality | General Practice |
| Location | 50 Leanni Way, Palm Coast, Florida |
| Authorized Official Name and Position | Michael Allen Osborne (OWNER) |
| Authorized Official Contact | 3862835997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Healthcare Partners, Llc 50 Leanni Way Suite D1 Palm Coast FL 32137 Ph: (386) 283-5997 | Coastal Healthcare Partners, Llc 50 Leanni Way Suite D1 Palm Coast FL 32137 Ph: (386) 283-5997 |
| NPI Number | 1053762740 |
|---|---|
| Provider Enumeration Date | 06/24/2016 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0244509149 |
|---|---|
| Medicare Enrollment ID | O20170710001136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053762740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME101968 (Florida) | Primary |
| Provider Name | Marisol E Arcila |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1972708584 PECOS PAC ID: 6002999695 Enrollment ID: I20080205000501 |
| Provider Name | Michael A Osborne |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205012689 PECOS PAC ID: 4183807936 Enrollment ID: I20110331000728 |
| Provider Name | Christopher Lee Wojcik |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366681413 PECOS PAC ID: 3971761321 Enrollment ID: I20120215000279 |
| Provider Name | Stacey N Harden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801334834 PECOS PAC ID: 0840569760 Enrollment ID: I20170710001674 |
| Provider Name | Michael T Warhurst |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1356791743 PECOS PAC ID: 0941593198 Enrollment ID: I20191001002436 |
| Provider Name | Brooke Lynae Boyer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366113441 PECOS PAC ID: 5294124939 Enrollment ID: I20211117003365 |
| Provider Name | Ethan Quinn |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275121014 PECOS PAC ID: 2769877364 Enrollment ID: I20220317001511 |
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