COASTAL INJURY CLINIC LLC


Address: 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233
Phone: 9045596638

COASTAL INJURY CLINIC LLC (NPI# 1437768033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437768033
Entity Type Organization
Organization Name COASTAL INJURY CLINIC LLC
Practice Address 2700 Riverside Ave Ste 1
Jacksonville
FL 32205-8233
Mailing Address Po Box 1869
Orange Park
FL 32067-1869
Practice Telephone 9045596638
Practice Fax Number 8889270401
Mailing Telephone 9045596638
Mailing Fax Number 8889270401
Enumeration Date 2020-07-29
Last Update Date 2020-07-29
Authorized Official Name MRS. ZANDA M CHANDLER (VICE PRESIDENT OF FINANCE)
Authorized Official Telephone 9042826331
Is Organization Subpart Y
Parent Organization Name PHYSICIANS GROUP SERVICES PA

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 174400000X Specialist Other Service Providers
N 207X00000X Orthopaedic Surgery Allopathic & Osteopathic Physicians
N 213E00000X Podiatrist Podiatric Medicine & Surgery Service Providers
Y 2081P2900X Physical Medicine & Rehabilitation
Specialization: Pain Medicine
Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
14011 Beach Blvd Ste 220, Jacksonville, FL 322501695 9045596638 8889270401
421 Kingsley Ave Ste 400, Orange Park, FL 320734898 9045596638 8889270401

Office Location

Street Address 2700 RIVERSIDE AVE STE 1
City JACKSONVILLE
State FL
Zip Code 32205-8233

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003466830 Brandon Neil Hillard Registered Nurse 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 2019-09-13
1720436363 Ericka Sampson Massage Therapist 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 2016-05-24
1578921631 Northstar Counseling Counselor 1672 Pershing Rd, Jacksonville, FL 32205 2016-02-04
1649645144 Magaly Perez-cruz Speech-Language Pathologist 4101-1 College Street, Jacksonville, FL 32205 2015-12-09
1639448723 First Choice Adult Daycare and Home Health Ca Specialist 5336 Quan Drive, Jacksonville, FL 32205 2011-12-20
1437434222 Christopher Styer Pharmacist 654 Casset Ave, Jacksonville, FL 32205 2011-10-12
1871827279 April Marie Felton Nurse Practitioner 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 2009-10-01
1922244821 Danielle Marie Sergent Physical Therapist 5222 Lenox Ave., Jacksonville, FL 32205 2008-12-23
1427181775 Lapp & Associates Behavioral Counselind Ctr Counselor 931 Cassat Avenue, Jacksonville, FL 32205 2007-03-14
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Taxonomy Information

Taxonomy Code 2081P2900X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Pain Medicine

Taxonomy Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962565457 Mark Charles Hofmann Physical Medicine & Rehabilitation 2968 Rainbow Rd, Jacksonville, FL 32217-2435 2006-12-18
1578669933 Jawed Hussain Physical Medicine & Rehabilitation 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 2006-09-15
1396792818 Allevia Medical, LLC Physical Medicine & Rehabilitation 14482 Cherry Lake Dr E, Jacksonville, FL 32258-5178 2006-05-29
1427011741 Frank R Collier Jr. Physical Medicine & Rehabilitation 2627 Riverside Ave Fl 3, Jacksonville, FL 32204-4712 2006-04-08
1467445403 Bao Tien Pham Physical Medicine & Rehabilitation 6816 Southpoint Pkwy, Suite 302, Jacksonville, FL 32216-1700 2005-08-24
1790045623 Kyle R Bovee Physical Medicine & Rehabilitation 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2012-05-25
1932428380 Monika Yogesh Patel Physical Medicine & Rehabilitation 655 W 8th St, Jacksonville, FL 32209-6511 2010-05-25
1124273529 Sunshine Spine and Pain, Pa Physical Medicine & Rehabilitation 3 Shircliff Way, Suite 610, Jacksonville, FL 32204-4757 2008-11-26
1215118062 Accmed Healthcare Systems Inc Physical Medicine & Rehabilitation 6816 Southpoint Pkwy, Suite 302, Jacksonville, FL 32216-1700 2007-11-21
1801000161 Ferdinand Joseph Formoso Physical Medicine & Rehabilitation 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 2007-05-09
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 32205

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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