| Coastal Spine And Pain Center | |
|
1865 Lime St Suite 101 Fernandina Beach FL 32034-4744 | |
| (904) 321-2422 | |
| (904) 321-2434 |
| Full Name | Coastal Spine And Pain Center |
|---|---|
| Speciality | Pain Medicine |
| Location | 1865 Lime St, Fernandina Beach, Florida |
| Authorized Official Name and Position | Andrew T Christman (CEO) |
| Authorized Official Contact | 9416857688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Spine And Pain Center 705 Wells Rd Ste 300 Orange Park FL 32073-2982 Ph: (904) 282-6331 | Coastal Spine And Pain Center 1865 Lime St Suite 101 Fernandina Beach FL 32034-4744 Ph: (904) 321-2422 |
| NPI Number | 1649584079 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 04/26/2024 |
| Medicare PECOS PAC ID | 1254238579 |
|---|---|
| Medicare Enrollment ID | O20150403000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649584079 | NPI | - | NPPES |
| 259123500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Primary |
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