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Organization
WEST COAST PEDIATRICS
Active
Organization
WEST COAST PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCE CHARLES-LOGAN M.D. (PHYSICIAN)
(941) 761-0663
Entity
Organization
Contact information
Practice address
1414 59TH STREET WEST, BRADENTON, FL 34209-4607
(941) 761-0663
(941) 761-3347
Mailing address
1414 59TH STREET WEST, BRADENTON, FL 34209-4607
(941) 761-0663
(941) 761-3347
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
08/28/2012
Last updated
02/07/2024
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