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Organization

COASTAL SHORELINE MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY L BORSHEIM (ADMINISTRATOR)
(813) 944-9365
Entity
Organization

Contact information

Practice address
12522 ROCKROSE GLN, LAKEWOOD RANCH, FL 34202-2827
(813) 944-9365
Mailing address
12522 ROCKROSE GLN, LAKEWOOD RANCH, FL 34202-2827
(813) 944-9365

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
10/10/2025
Last updated
10/10/2025
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