Organization
COASTALMDLIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY NEIL MD (OWNER/PHYSICIAN)
(850) 860-4679
Entity
Organization
Contact information
Practice address
913 GULF BREEZE PKWY STE 3, GULF BREEZE, FL 32561-4728
(850) 860-4679
Mailing address
913 GULF BREEZE PKWY STE 3, GULF BREEZE, FL 32561-4728
(850) 860-4679
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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