COASTAL VEIN & VASCULAR INSTITUTE, LLC (NPI# 1689052359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689052359 |
| Entity Type | Organization |
| Organization Name | COASTAL VEIN & VASCULAR INSTITUTE, LLC |
| Practice Address |
7741 Point Meadows Dr Unit 104-106 Jacksonville FL 32256-9182 |
| Mailing Address |
3599 University Blvd S Bldg 300 Jacksonville FL 32216-4252 |
| Practice Telephone | 9043995550 |
| Practice Fax Number | 9043464334 |
| Mailing Telephone | 9043995550 |
| Mailing Fax Number | 9043464334 |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2016-02-16 |
| Authorized Official Name | KURT W MORI (PRESIDENT) |
| Authorized Official Telephone | 9043995550 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | DRS. MORI, BEAN & BROOKS, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
7741 POINT MEADOWS DR UNIT 104-106 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-9182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235670621 | Cristal Boatright | Physician Assistant | 7741 Point Meadows Dr, Unit 104, Jacksonville, FL 32256-9201 | 2017-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972681542 | Kok L. Chong | Radiology | 800 Lomax St, Suite 100a, Jacksonville, FL 32204-3927 | 2006-11-01 |
| 1730189739 | James K St George | Radiology | 8767 Perimeter Park Blvd, Jacksonville, FL 32216-5479 | 2005-08-01 |
| 1003478827 | Physician Group Holdings, LLC | Radiology | 10210 San Jose Blvd Ste 4, Jacksonville, FL 32257-6271 | 2019-07-01 |
| 1992294938 | Christopher Gammarano | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2018-05-04 |
| 1457770604 | Jehan L Shah | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2014-04-15 |
| 1184069411 | Altan Fareed Ahmed | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2013-04-30 |
| 1902169527 | Daniel George | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2012-06-19 |
| 1336408020 | Saeed Bashir | Radiology | 655 W 8th St, Jacksonville, FL 32209-6511 | 2012-05-15 |
| 1659639169 | Zlatko Devcic | Radiology | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2012-05-03 |
| 1669771168 | American Access Care of Jacksonville LLC | Radiology | 2416 Dunn Ave, Jacksonville, FL 32218-4604 | 2011-03-23 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
Please comment or provide details below to improve the information on COASTAL VEIN & VASCULAR INSTITUTE, LLC.
| 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.