Organization
COASTAL ORTHOPAEDICS & SPORTS MEDICINE CENTER
Active
Other names
Coastal Orthopaedic & Sports Medicine Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD JESUS ROSSARIO MD (PRESIDENT)
(772) 335-5300
Entity
Organization
Contact information
Practice address
7710 S US HIGHWAY 1, PORT SAINT LUCIE, FL 34952-2320
(772) 335-5300
(772) 873-3004
Mailing address
7710 S US HIGHWAY 1, PORT SAINT LUCIE, FL 34952-2320
(772) 335-5300
(772) 873-3004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33747
BCBS GROUP
FL
Enumeration date
03/31/2006
Last updated
01/07/2020
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