Organization
COAST MULTI-SPECIALTY MEDICAL GROUP P.A
Active
Other names
CMSMG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. ANTHONY TROTT M.D. (PRESIDENT)
(386) 758-1965
Entity
Organization
Contact information
Practice address
480 SW MAIN BLVD, LAKE CITY, FL 32025-5269
(386) 758-1965
(386) 758-6923
Mailing address
PO BOX 1762, LAKE CITY, FL 32056-1762
(386) 758-1965
(386) 758-6923
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME80264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K2456
MEDICARE GROUP PTAN
FL
Enumeration date
02/23/2007
Last updated
12/23/2014
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