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Organization

COASTAL PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEAN CLAUDE JEANTY M.D. (OWNER)
(386) 672-1490
Entity
Organization

Contact information

Practice address
1275 W GRANADA BLVD, SUITE 3A, ORMOND BEACH, FL 32174-8259
(386) 672-1490
(386) 672-1628
Mailing address
1275 W GRANADA BLVD, SUITE 3A, ORMOND BEACH, FL 32174-8259
(386) 672-1490
(386) 672-1628

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
06/14/2007
Last updated
08/22/2020
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