Organization
COASTAL ORTHOPAEDICS AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER DAVID CANDELORA MD (PRACTICE OWNER)
(727) 848-1417
Entity
Organization
Contact information
Practice address
5145 DEER PARK DR, NEW PORT RICHEY, FL 34653-7013
(727) 848-1417
(727) 847-7526
Mailing address
5145 DEER PARK DRIVE, NEW PORT RICHEY, FL 34653
(727) 848-1417
(727) 847-7526
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD6290
RAILROAD MEDICARE
—
Enumeration date
05/16/2006
Last updated
06/16/2025
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