Organization
COASTAL ANESTHESIOLOGY CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(877) 328-1119
Entity
Organization
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 819-4478
(904) 819-4993
Mailing address
5565 CENTERVIEW DR STE 107, RALEIGH, NC 27606-3563
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98677
BCBS OF FLORIDA
—
Enumeration date
08/05/2008
Last updated
07/22/2021
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