COASTAL THERAPY ASSOCIATE LLC (NPI# 1790277689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790277689 |
| Entity Type | Organization |
| Organization Name | COASTAL THERAPY ASSOCIATE LLC |
| Practice Address |
3050 W Highway 98 Unit B7 Port St Joe FL 32456-4718 |
| Practice Telephone | 8502095935 |
| Mailing Telephone | 8502095935 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MRS. KATHRYN MAE LAND (PARTNER) |
| Authorized Official Telephone | 8502095935 |
| Authorized Official Credential | PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2801262 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3050 W HIGHWAY 98 UNIT B7 |
| City | PORT ST JOE |
| State | FL |
| Zip Code | 32456-4718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609379825 | Melanie Q Larry | Case Manager/Care Coordinator | 212 W. Highway 98, Suite C Town Center Plaza, Port St. Joe, FL 32456 | 2018-03-14 |
| 1972029833 | Tem Medical | Internal Medicine | 220 9th Street, Port St Joe, FL 32456 | 2017-08-22 |
| 1770018731 | Gulf County Association for Retarded Citizens, Inc. | Non-emergency Medical Transport (VAN) | 122 Water Plant Road, Port St Joe, FL 32456 | 2017-04-27 |
| 1477815488 | Patricia J Mitchell | Nurse Practitioner | 256 Canal Street, Port Saint Joe, FL 32456 | 2012-06-14 |
| 1407135296 | Chrystal R Cox | Occupational Therapist | 6801 Us Highway 98, Port St. Joe, FL 32456 | 2011-08-10 |
| 1467662957 | William Rex Buzzett | Pharmacist | 302 Cecil G Costin Blvd, Port St Joe, FL 32456 | 2007-05-23 |
| 1831293802 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 110 Hwy 98, Port Saint Joe, FL 32456 | 2006-09-12 |
| 1427160571 | Shoreline Medical Group, P.a. | Internal Medicine | 419 Baltzell Ave, Port St Joe, FL 32456 | 2006-08-31 |
| 1851403992 | Elizabeth F Curry | Pediatrics | 3871 E Highway 98 Ste 201, Port St Joe, FL 32456 | 2006-08-31 |
| 1891715702 | Champion Medical Equipment Rental &sales LLC | Durable Medical Equipment & Medical Supplies | 324 Long Ave Port St, Joe, FL 32456 | 2006-07-20 |
| Find all providers in zip 32456 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336832 | Marco Desouza | Nurse Practitioner | 10235 Avelar Ridge Dr, Riverview, FL 33578-7560 | 2020-11-02 |
| 1457950107 | Janet Rosemarie Walker | Nurse Practitioner | 9988 Sw 38th Ave, Ocala, FL 34476-4082 | 2020-10-23 |
| 1104425800 | Vijayalakshmi Kumaraguru | Nurse Practitioner | 102 Park Place Blvd Ste D1, Kissimmee, FL 34741-2358 | 2020-10-22 |
| 1356940217 | Smitha Ajesh | Nurse Practitioner | 9833 Westview Dr Apt 829, Coral Springs, FL 33076-2537 | 2020-10-21 |
| 1457959066 | Kecia Hicks | Nurse Practitioner | 691 Institution Rd, Defuniak Springs, FL 32433-1850 | 2020-10-15 |
| 1699372003 | Rosie Michel | Nurse Practitioner | 13000 Ne 12th Ave, North Miami, FL 33161-4305 | 2020-10-08 |
| 1952908352 | Karen Weinstock | Nurse Practitioner | 7148 Sportsmans Dr, North Lauderdale, FL 33068-5456 | 2020-10-08 |
| 1396342754 | Pamela Ziel | Nurse Practitioner | 545 Lakeside Cir, Sunrise, FL 33326-2136 | 2020-10-07 |
| 1922615608 | Urszula Dorfman | Nurse Practitioner | 1 Las Olas Cir Apt 609, Fort Lauderdale, FL 33316-1634 | 2020-09-28 |
| 1073129136 | Karen Harris | Nurse Practitioner | 28211 Church Rd, Brooksville, FL 34602-6232 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST JOE |
| Zip Code | 32456 |
Please comment or provide details below to improve the information on COASTAL THERAPY ASSOCIATE LLC.
| 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.