Organization
COASTAL ANESTHESIA, P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EDERER DO (DO/PRESIDENT)
(352) 867-8898
Entity
Organization
Contact information
Practice address
1001 COLLEGE BLVD W STE H, NICEVILLE, FL 32578-1049
(850) 279-4417
(850) 279-4212
Mailing address
PO BOX 10583, BIRMINGHAM, AL 35202-0583
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98947
BCBS FL
FL
01
—
DE0932
RAILROAD MEDICARE
FL
Enumeration date
09/16/2006
Last updated
07/21/2022
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