Organization
COASTAL VASCULAR AND INTERVENTIONAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANELLE FISCHER (ADMINISTRATOR)
(850) 479-1805
Entity
Organization
Contact information
Practice address
1851 N 9TH AVE STE A&B, PENSACOLA, FL 32503-5201
(850) 479-1805
(850) 479-1829
Mailing address
PO BOX 11982, PENSACOLA, FL 32524-1982
(850) 479-1805
(850) 479-1829
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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