Organization
COASTAL CARE AND WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M QADIR PA-C (OWNER)
(561) 688-9565
Entity
Organization
Contact information
Practice address
2100 SE HILLMOOR DR STE 101, PORT ST LUCIE, FL 34952-8057
(561) 262-8785
Mailing address
612 SE FLAMINGO AVE, STUART, FL 34996-3249
(561) 262-8785
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
10/16/2025
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