Organization
COASTLINE IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES EAKER (PRESIDENT)
(321) 253-2700
Entity
Organization
Contact information
Practice address
2290 W EAU GALLIE BLVD, SUITE 108, MELBOURNE, FL 32935-3133
(321) 253-2700
(321) 253-2267
Mailing address
2290 W EAU GALLIE BLVD, SUITE 104, MELBOURNE, FL 32935-3133
(321) 253-2700
(321) 253-2267
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
HCC3989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264871701
—
FL
Enumeration date
11/15/2007
Last updated
04/28/2022
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