| Coastal Skilled Care Providers Llc | |
|
767 Timothy St Ormond Beach FL 32174-2909 | |
| (407) 496-9399 | |
| Not Available |
| Full Name | Coastal Skilled Care Providers Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 767 Timothy St, Ormond Beach, Florida |
| Authorized Official Name and Position | Lothar Michael Gebauer (OFFICER) |
| Authorized Official Contact | 4074969399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Skilled Care Providers Llc 767 Timothy St Ormond Beach FL 32174-2909 Ph: (407) 496-9399 | Coastal Skilled Care Providers Llc 767 Timothy St Ormond Beach FL 32174-2909 Ph: (407) 496-9399 |
| NPI Number | 1508272683 |
|---|---|
| Provider Enumeration Date | 07/09/2014 |
| Last Update Date | 07/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508272683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME98984 (Florida) | Primary |
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