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Organization
COASTAL VASCULAR AND INTERVENTIONAL PLLC
Active
Organization
COASTAL VASCULAR AND INTERVENTIONAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER J LECROY MD (OWNER, PHYSICIAN)
(850) 479-1805
Entity
Organization
Contact information
Practice address
5149 N. 9TH AVENUE, SUITE 120, PENSACOLA, FL 32504-8734
(850) 479-1805
(850) 479-1829
Mailing address
P.O. BOX 11982, PENSACOLA, FL 32524-1982
(850) 479-7200
(850) 479-1829
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000700100
—
FL
Enumeration date
11/05/2008
Last updated
06/12/2020
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