COASTAL SENIOR HEALTHCARE INC


Address: 3914 E State Road 64, Bradenton, FL 34208-9059
Phone: 9412163800

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QG0300X Family Medicine
Specialization: Geriatric Medicine
Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
5614 Cloverleaf Run, Bradenton, FL 342114048 8602504488

Office Location

Street Address 3914 E STATE ROAD 64
City BRADENTON
State FL
Zip Code 34208-9059

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207QG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Geriatric Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356826770 Walsh Family Medicine LLC Family Medicine 5818 Tidewater Preserve Blvd, Bradenton, FL 34208-5740 2018-10-02

Providers in the same taxonomy and state

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
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Competitor

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City BRADENTON
Zip Code 34208

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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