Organization
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC
Active
Other names
Coastal Cardiovascular & Thoracic Associates, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM HAMPTON JOHNSON III M.D. (OPERATING MANAGER)
(386) 672-9503
Entity
Organization
Contact information
Practice address
1240 W GRANADA BLVD FL 2, ORMOND BEACH, FL 32174-5915
(862) 366-8543
(862) 632-9963
Mailing address
1240 W GRANADA BLVD FL 2, ORMOND BEACH, FL 32174-5915
(386) 236-6854
(386) 263-2996
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
ME36700
FL
2086S0129X
Vascular Surgery Physician
ME58979
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME36700
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME58979
FL
Other
Enumeration date
11/01/2013
Last updated
01/21/2025
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