COASTAL PHYSICAL THERAPY LLC (NPI# 1275768194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275768194 |
| Entity Type | Organization |
| Organization Name | COASTAL PHYSICAL THERAPY LLC |
| Practice Address |
18990 Persimmon Ridge Rd Alva FL 33920-3367 |
| Mailing Address |
Po Box 62095 Fort Myers FL 33906-2095 |
| Practice Telephone | 9416810278 |
| Practice Fax Number | 2392360217 |
| Mailing Telephone | 9416810278 |
| Mailing Fax Number | 2392360217 |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2010-09-16 |
| Authorized Official Name | VANESSA RACHEL MARTIN (PRESIDENT) |
| Authorized Official Telephone | 19416810278 |
| Authorized Official Credential | MSPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT23483 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CCN | 920922584420-002 | 01 |
| FL | MEDICARE NUMBER | AN9692Z | 01 |
| FL | PTAN | CM700A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043375520 | Coastal Physical Therapy LLC | Physical Therapist | 580 5th St, Suite 600, Brookings, OR 97415-8329 | 2006-12-26 |
| Street Address |
18990 PERSIMMON RIDGE RD |
| City | ALVA |
| State | FL |
| Zip Code | 33920-3367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154813772 | Asja Morello | Specialist/Technologist | 17651 Oak Creek Road, Alva, FL 33920 | 2018-05-30 |
| 1205102084 | Edward Clewell | Social Worker | 2108 Monroe Ave, Alva, FL 33920-1421 | 2012-03-27 |
| 1396863759 | Ralph Santana | Physical Therapist | 21591 Claytor Rd, Alva, FL 33920-3303 | 2007-03-26 |
| 1174923635 | Michelle Asha Handy | Pharmacist | 1830 Oak Dr, Alva, FL 33920-3707 | 2014-09-02 |
| 1639347149 | Cynthia Mansell Witthuhn | Registered Nurse | 2121 Sebastian Ct, Alva, FL 33920-3824 | 2008-02-19 |
| 1225225105 | Kathryn Barnes Snider | Physical Therapist | 3130 Styles Rd, Alva, FL 33920-4003 | 2007-09-25 |
| 1134569122 | Claudine Rene Blackburn | Speech-Language Pathologist | 2770 Styles Rd, Alva, FL 33920-4017 | 2013-07-05 |
| 1568787521 | Christmas Community Residential Home | Assisted Living Facility | 16691 1st St, Alva, FL 33920-4119 | 2010-04-02 |
| 1396177184 | Willie Christmas | Custodial Care Facility | 16691 1st St, Alva, FL 33920-4119 | 2013-08-02 |
| 1699284067 | Christal Bolden | Adult Companion | 23061 Solomon Dr, Alva, FL 33920-4131 | 2017-09-28 |
| Find all providers in zip 33920 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
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| 1306445754 | Concierge Rehab Inc | Clinic/Center | 1045 E Heritage Club Cir, Delray Beach, FL 33483-3483 | 2020-10-17 |
| 1689272627 | Ucdm Services Inc | Clinic/Center | 12030 Sw 129th Ct Ste 103, Miami, FL 33186-4584 | 2020-10-12 |
| 1902404163 | Frontline Physical Therapy | Clinic/Center | 8655 Bayou Way N, Pinellas Park, FL 33782-4549 | 2020-10-11 |
| 1891393138 | Venice Physical Therapy and Sports Medicine | Clinic/Center | 1776 S Tamiami Trl, Venice, FL 34293-1602 | 2020-10-09 |
| 1750988812 | Angeles Medical Center,inc. | Clinic/Center | 8725 Nw 18th Ter Ste 403, Doral, FL 33172-2610 | 2020-10-02 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.