Organization
COASTAL RADIOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY ROSS BROBECK M.D. (PRESIDENT)
(850) 399-0998
Entity
Organization
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 315-7807
Mailing address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 315-7807
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
04/13/2009
Last updated
07/31/2009
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