| Coastal Pain Management Pllc | |
|
14 Live Oak St Ste C-4 Gulf Breeze FL 32561-4484 | |
| (850) 490-8862 | |
| (937) 915-0250 |
| Full Name | Coastal Pain Management Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Live Oak St Ste C-4, Gulf Breeze, Florida |
| Authorized Official Name and Position | Laura Tunke (OWNER) |
| Authorized Official Contact | 8504908862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Pain Management Pllc 14 Live Oak St Ste C-4 Gulf Breeze FL 32561-4484 Ph: () - | Coastal Pain Management Pllc 14 Live Oak St Ste C-4 Gulf Breeze FL 32561-4484 Ph: (850) 490-8862 |
| NPI Number | 1609499524 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 06/01/2020 |
| Medicare PECOS PAC ID | 2769804079 |
|---|---|
| Medicare Enrollment ID | O20200615002027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609499524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Laura M Tunke |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588981849 PECOS PAC ID: 8224348842 Enrollment ID: I20151112000042 |
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