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Organization
COASTAL COMPLETE CARE, PA
Active
Organization
COASTAL COMPLETE CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE PORTWOOD (BILLING MANAGER)
(850) 584-6000
Entity
Organization
Contact information
Practice address
100 PLANTATION RD, PERRY, FL 32348-6000
(850) 584-6000
Mailing address
100 PLANTATION RD, PERRY, FL 32348-6000
(850) 584-6000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
FL
208D00000X
General Practice Physician
—
FL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/29/2014
Last updated
10/18/2018
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