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Organization

COQUINA CENTER, LLC

Active
Other names
Coquina Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JENNIFER ALISE ZIOLKOWSKI MBA (VP FINANCE)
(813) 558-6629
Entity
Organization

Contact information

Practice address
170 N CENTER ST, ORMOND BEACH, FL 32174-5186
(386) 672-7113
(386) 672-7128
Mailing address
170 N CENTER ST, ORMOND BEACH, FL 32174-5186
(386) 672-7113
(386) 672-7128

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF13470961
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004438178
AETNA
FL
05
026064900
FL
01
71-00466
UNITED HEALTH CARE
FL
01
C105589
UNITED AMERICAN
FL
01
K4Z
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/13/2005
Last updated
06/12/2024
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