Organization
COASTAL MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G JACKSON (EXECUTIVE DIRECTOR)
(941) 309-7006
Entity
Organization
Contact information
Practice address
1 S SCHOOL AVE, SUITE 103, SARASOTA, FL 34237-6014
(941) 308-8500
(941) 308-8501
Mailing address
1 S SCHOOL AVE, SUITE 103, SARASOTA, FL 34237-6014
(941) 308-8500
(941) 308-8501
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1114
FL
Other
Enumeration date
11/14/2006
Last updated
12/30/2010
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