Organization
COASTAL MOBILE ULTRASOUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA FERKETICH (OWNER)
(904) 494-8560
Entity
Organization
Contact information
Practice address
4 LONG LAKE WAY, PALM COAST, FL 32137-1617
(904) 494-8560
Mailing address
4 LONG LAKE WAY, PALM COAST, FL 32137-1617
(904) 494-8560
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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