# COASTAL PRACTICE MANAGEMENT LLC

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

## Provider details

- **NPI number:** 1992937528
- **Authorized official:** MR. KEVIN LANGLEY (MANAGER)
- **Authorized official phone:** (941) 302-0215

## Contact information

- **Practice address:** 4949 E STATE ROAD 64, \#142, BRADENTON, FL 34208-5530
- **Practice address phone:** (941) 302-0215
- **Practice address fax:** (941) 896-6531
- **Mailing address:** 4949 E STATE ROAD 64, \#142, BRADENTON, FL 34208-5530
- **Mailing address phone:** (941) 302-0215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/16/2009
- **Last updated:** 08/16/2009