Organization
COASTAL CARDIOLOGY P A
Active
Organization
COASTAL CARDIOLOGY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A. CONRAD M.D. (STAFF PHYSICIAN)
(239) 274-8866
Entity
Organization
Contact information
Practice address
16261 BASS RD, SUITE 300, FORT MYERS, FL 33908-3671
(239) 274-8866
(239) 274-8867
Mailing address
PO BOX 24853, MIAMI, FL 33102-4853
(239) 274-8866
(239) 274-8867
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273264500
—
FL
01
—
74608
BCBS
FL
01
—
DD8590
RR MEDICARE
FL
Enumeration date
04/20/2006
Last updated
05/24/2010
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