Organization
COASTAL UROLOGY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE THUY NGUYEN (OFFICE MANAGER)
(850) 837-0442
Entity
Organization
Contact information
Practice address
4012 COMMONS DR W, SUITE 100, DESTIN, FL 32541-8422
(850) 837-0442
(850) 837-1051
Mailing address
PO BOX 936, SHALIMAR, FL 32579-0936
(850) 837-0442
(850) 837-1051
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME72919
FL
Other
Enumeration date
08/25/2006
Last updated
08/22/2020
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