Organization
COASTAL MEDICAL SERVICE MANAGMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANN PAYNE (CFO)
(727) 785-4540
Entity
Organization
Contact information
Practice address
3820 TAMPA ROAD, SUITE #202, PALM HARBOR, FL 34684
(727) 785-4540
(727) 773-9716
Mailing address
3820 TAMPA ROAD, SUITE #202, PALM HARBOR, FL 34684
(727) 785-4540
(727) 773-9716
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0047065
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046784700
—
FL
Enumeration date
06/06/2008
Last updated
11/01/2010
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