COASTAL SENIOR HEALTHCARE INC (NPI# 1497289110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497289110 |
Entity Type | Organization |
Organization Name | COASTAL SENIOR HEALTHCARE INC |
Practice Address |
3914 E State Road 64 Bradenton FL 34208-9059 |
Practice Telephone | 9412163800 |
Practice Fax Number | 9412163703 |
Mailing Telephone | 9412163800 |
Mailing Fax Number | 9412163703 |
Enumeration Date | 2017-04-19 |
Last Update Date | 2019-04-24 |
Authorized Official Name | MR. JOHN K MCDERMOTT (PRESIDENT) |
Authorized Official Telephone | 9412163800 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
5614 Cloverleaf Run, Bradenton, FL 342114048 | 8602504488 |
Street Address |
3914 E STATE ROAD 64 |
City | BRADENTON |
State | FL |
Zip Code | 34208-9059 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619906799 | Cassie Jo Leutzinger | Psychologist | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2006-07-01 |
1144874371 | Lauren Jean Amorello | Nurse Practitioner | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2019-07-25 |
1770039372 | Kristi Cay Kita | Nurse Practitioner | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2016-09-01 |
1659768950 | Gulfside Behavioral Care Np Inc | Nurse Practitioner | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2015-04-24 |
1396010229 | Va Im | Nurse Practitioner | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2012-03-09 |
1508151838 | Regina L Soderberg | Nurse Practitioner | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2011-06-15 |
1023251352 | Stacy Lee Sauer | Nurse Practitioner | 3914 E State Road 64, Bradenton, FL 34208-9059 | 2009-04-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740880566 | Michael Gerard Kulikowski | Pharmacist | 6225 E Sr 64, Bradenton, FL 34208 | 2020-10-30 |
1104431964 | Genesis Carrillo | Pharmacist | 4210 E, Fl-64, Bradenton, FL 34208 | 2020-09-09 |
1962960146 | Elite Surgery Center, LLC | Plastic Surgery | 5301 4th Ave Circle E, Bradenton, FL 34208 | 2019-03-07 |
1740777101 | Chinelo Uche | Student in an Organized Health Care Education/Training Program | 206 2nd St. E, Brandenton, FL 34208 | 2018-04-20 |
1396240040 | Nicholas Guy Ross | Student in an Organized Health Care Education/Training Program | 206 2nd St E., Bradenton, FL 34208 | 2018-03-26 |
1881196566 | Pinnacle Dental, Inc | Dentist | 5220 4th Ave. Circle E., Bradenton, FL 34208 | 2018-03-08 |
1194240176 | Bradenton Community Acupuncture | Acupuncturist | 5245 Office Park Blvd Suite 103, Bradenton, FL 34208 | 2017-08-10 |
1316490147 | Loretta Michele Deloach | Counselor | 515 27th St. S., Ste. 3, Bradenton, FL 34208 | 2016-07-28 |
1730548934 | Elodie Chimuanya Epane Kamdem | Dentist | Bright Now Dentalst, 650, 3611 1st Street, Suiyr, Bradenton, FL 34208 | 2016-02-16 |
1215303920 | Lesley Ann White | Driver | 45 Palmwood, Bradenton, FL 34208 | 2015-08-17 |
Find all providers in zip 34208 |
Taxonomy Code | 207QG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Geriatric Medicine |
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356826770 | Walsh Family Medicine LLC | Family Medicine | 5818 Tidewater Preserve Blvd, Bradenton, FL 34208-5740 | 2018-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821620618 | Heather J Cappello LLC | Family Medicine | 2571 Dick Wilson Dr, Sarasota, FL 34240-8722 | 2020-02-10 |
1225682784 | Brevard Geriatrics, LLC | Family Medicine | 720 E New Haven Ave Suite 11, Melbourne, FL 32901-5474 | 2019-08-01 |
1922562933 | Bless Medical Center Corp | Family Medicine | 440 E Sample Road Suite 107, Pompano Beach, FL 33064 | 2019-01-23 |
1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
1184137929 | Saint George Medical Center Inc | Family Medicine | 1118 Hospital Rd, Fort Walton Beach, FL 32547-6742 | 2017-11-15 |
1750835211 | Gainesville Geriatric Rehabilitation Medicine LLC | Family Medicine | 5002 Nw 15th Pl, Gainesville, FL 32605-4555 | 2016-08-12 |
1033570171 | Reliance Med, LLC | Family Medicine | 8450 Reymont St, Orlando, FL 32827-7430 | 2016-03-17 |
1013375062 | Kravitz Physician Services, P.a. | Family Medicine | 5150 Nw 82nd Ter, Coral Springs, FL 33067-2811 | 2016-02-05 |
1972968089 | Wm R George II Md Pa | Family Medicine | 327 Plaza Real Ste 307, Boca Raton, FL 33432-3944 | 2015-12-17 |
1710369020 | Robert N. Baskin, Md, P.a. | Family Medicine | 2108 N Golfview Dr, Plant City, FL 33566-6768 | 2015-06-23 |
Find all providers with the same taxonomy |
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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.