COASTLINE IMAGING INC (NPI# 1437330750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437330750 |
| Entity Type | Organization |
| Organization Name | COASTLINE IMAGING INC |
| Practice Address |
1341 Medical Park Dr Suite 101 Melbourne FL 32901-3235 |
| Mailing Address |
2290 W Eau Gallie Blvd Suite 104 Melbourne FL 32935-3133 |
| Practice Telephone | 3212532700 |
| Practice Fax Number | 3212532267 |
| Mailing Telephone | 3212532700 |
| Mailing Fax Number | 3212532267 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2009-10-27 |
| Authorized Official Name | JAMES EAKER (PRESIDENT) |
| Authorized Official Telephone | 3212532700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | HCC6115 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 264871701 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679802599 | Coastline Imaging Inc | Occupational Therapy Assistant | 1341 Medical Park Dr, Ste. 202, Melbourne, FL 32901-3235 | 2009-12-24 |
| 1184805491 | Coastline Imaging Inc | Specialist | 2290 W Eau Gallie Blvd, Suite 108, Melbourne, FL 32935-3133 | 2007-11-15 |
| 1770576167 | Coastline Imaging Inc | Radiology | 2290 W Eau Gallie Blvd, Ste 104, Melbourne, FL 32935-3133 | 2005-08-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COASTLINE IMAGING INC | 2290 W Eau Gallie Blvd Ste 104, Melbourne, FL 32935-3134 |
| Street Address |
1341 MEDICAL PARK DR SUITE 101 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293859 | Atlantic Orthopaedic Group Pa | Specialist | 1341 Medical Park Dr, Ste 201, Melbourne, FL 32901-3235 | 2005-05-23 |
| 1942678958 | Mark William Snavely | Physician Assistant | 1341 Medical Park Dr, Suite 201, Melbourne, FL 32901-3235 | 2015-09-08 |
| 1679802599 | Coastline Imaging Inc | Occupational Therapy Assistant | 1341 Medical Park Dr, Ste. 202, Melbourne, FL 32901-3235 | 2009-12-24 |
| 1861663239 | Andrew T Sander | Physician Assistant | 1341 Medical Park Dr, Suite 201, Melbourne, FL 32901-3235 | 2008-03-13 |
| 1134262710 | Stephen Emile Theriault | Physician Assistant | 1341 Medical Park Dr, Suite 201, Melbourne, FL 32901-3235 | 2007-02-14 |
| 1568569531 | Terry David Johnson | Occupational Therapist | 1341 Medical Park Dr, 201, Melbourne, FL 32901-3235 | 2006-09-20 |
| 1265492938 | Russell Emmett Davis IIi | Occupational Therapist | 1341 Medical Park Dr, Melbourne, FL 32901-3235 | 2006-03-25 |
| 1740271717 | David W Ferguson | Physician Assistant | 1341 Medical Park Dr, 201, Melbourne, FL 32901-3235 | 2005-10-31 |
| 1093706079 | Margaret L Avilla | Physician Assistant | 1341 Medical Park Dr, 201, Melbourne, FL 32901-3235 | 2005-10-31 |
| 1447256284 | Josse Anthony Mazo-mayorquin | Psychiatry & Neurology | 1341 Medical Park Dr, Suite 101 A, Melbourne, FL 32901-3235 | 2005-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758893 | Ursula Olazabal | Specialist | 402 N Babcock St Ste 101, Melbourne, FL 32935-7335 | 2020-10-18 |
| 1588101604 | Brevard County Orthopedic & Spine Associates LLC | Specialist | 2090 Sarno Rd, Melbourne, FL 32935-3077 | 2017-01-26 |
| 1962809897 | Independent Lung Associates, Pa | Specialist | 1314 Oak Street, Melbourne, FL 32901 | 2014-11-20 |
| 1043583289 | Kelly M Lieneke | Specialist | 6300 N Wickham Rd Ste 116, Melbourne, FL 32940-2023 | 2012-02-20 |
| 1609165794 | Sumeet Thareja | Specialist | 675 S Babcock Street, Melbourne, FL 32901-1459 | 2011-03-29 |
| 1447583943 | Charla Jean Green | Specialist | 601 E Strawbridge Ave, Melbourne, FL 32901-4733 | 2009-09-15 |
| 1104077841 | Denise Elliott | Specialist | 2447 N Wickham Rd Ste 138, Pmb 147, Melbourne, FL 32935-8127 | 2008-09-30 |
| 1649442047 | East Shore Neurology Pa | Specialist | 240 N Wickham Rd Ste 110, Melbourne, FL 32935-8663 | 2008-03-26 |
| 1144408378 | Richard E Goulding | Specialist | 817 Hogan Way, Melbourne, FL 32940-1789 | 2008-02-11 |
| 1942414420 | Kathleen Savarese | Specialist | 2811 Cameron St, Melbourne, FL 32901-7011 | 2007-05-10 |
| Find all providers in MELBOURNE | ||||
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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.