# COASTLINE THERAPY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215827837
- **Authorized official:** CHELSEA MIKLOS CCC-SLP (OWNER)
- **Authorized official phone:** (678) 428-0733

## Contact information

- **Practice address:** 17706 CRESCENT MOON LOOP, LAKEWOOD RANCH, FL 34211-1358
- **Practice address phone:** (678) 428-0733
- **Mailing address:** 17706 CRESCENT MOON LOOP, LAKEWOOD RANCH, FL 34211-1358
- **Mailing address phone:** (678) 428-0733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2025
- **Last updated:** 07/07/2025