# COASTAL ORTHOPEDIC CENTER

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

## Provider details

- **NPI number:** 1972745743
- **Authorized official:** JOSEPH PERRETTA CP (PRESIDENT)
- **Authorized official phone:** (772) 871-9200

## Contact information

- **Practice address:** 3954 US HIGHWAY 27 S, SEBRING, FL 33870-5511
- **Practice address phone:** (772) 871-9200
- **Practice address fax:** (772) 336-4040
- **Mailing address:** 510 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-1943
- **Mailing address phone:** (772) 871-9200
- **Mailing address fax:** (772) 336-4040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PRO 84 | FL | Yes |

## Other

- **Enumeration date:** 03/25/2009
- **Last updated:** 03/25/2009