Organization
COASTAL DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIDDHARTH SHAH MD (DOCTOR)
(888) 395-4007
Entity
Organization
Contact information
Practice address
999 YAMATO RD, SUITE 210, BOCA RATON, FL 33431-4477
(888) 395-4007
Mailing address
999 YAMATO RD, SUITE 210, BOCA RATON, FL 33431-4477
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME 68165
FL
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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