Organization
COAST FLORIDA P.A.
Active
Parent organization
COAST FLORIDA P.A.
Other names
Coast Dental-Melbourne
Organization subpart
Yes
Provider details
NPI number
Legal business name
COAST FLORIDA P.A.
Authorized official
MELODY RIVERA (CREDENTIALING MANAGER)
(813) 350-7166
Entity
Organization
Contact information
Practice address
7777 N WICKHAM RD STE 4, MELBOURNE, FL 32940-7978
(321) 255-6303
(321) 255-6710
Mailing address
5706 BENJAMIN CENTER DR STE 103, TAMPA, FL 33634-5262
(813) 350-7166
(813) 434-2325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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