COASTAL CARE MEDICAL CENTER INC (NPI# 1902970684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902970684 |
| Entity Type | Organization |
| Organization Name | COASTAL CARE MEDICAL CENTER INC |
| Other Organization Name | COASTAL CARE MEDICAL CENTER |
| Practice Address |
11761 Beach Blvd Suite 8 Jacksonville FL 32246-6615 |
| Practice Telephone | 9046423304 |
| Practice Fax Number | 9049283561 |
| Mailing Telephone | 9046423304 |
| Mailing Fax Number | 9049283561 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-01-06 |
| Authorized Official Name | DR. CLINT D MILLER (PRESIDENT) |
| Authorized Official Telephone | 9046423304 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Coastal Care Medical Center | Former Legal Business Name - Organization |
| Street Address |
11761 BEACH BLVD SUITE 8 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32246-6615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083681357 | Laurel Elizabeth Herron | Physician Assistant | 11761 Beach Blvd, Ufjax - St. Johns Bluff Primary Care, Jacksonville, FL 32246-6615 | 2006-03-04 |
| 1134505472 | Carmen Daniela Riza | Nurse Practitioner | 11761 Beach Blvd, Ste 8, Jacksonville, FL 32246-6615 | 2015-08-10 |
| 1407172018 | Coastal Plus Medical Center Inc | Clinic/Center | 11761 Beach Blvd, Suite 8, Jacksonville, FL 32246-6615 | 2010-04-08 |
| 1467403824 | Clint D. Miller | Chiropractor | 11761 Beach Blvd, Suite 8, Jacksonville, FL 32246-6615 | 2006-05-12 |
| 1053370452 | Clara Ines Chaves | Family Medicine | 11761 Beach Blvd, Ufjp St Johns Bluff Primary Care, Jacksonville, FL 32246-6615 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275179863 | Samar A Ibrahim | Pharmacist | 1305 N Orange Ave Green Cove Springs, Jacksonville, FL 32246 | 2019-11-19 |
| 1386290898 | Kelsey R Clevenger | Chiropractor | 4413 Town Center Parkway, Ste. 205, Jacksonville, FL 32246 | 2019-08-12 |
| 1700449006 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4712 Lake Center Drive, Space 107, Jacksonville, FL 32246 | 2019-04-22 |
| 1205399946 | Usa United Surgical Assistants | Clinic/Center | Bahri Surgical Center, 9726 Touchton Rd, Jacksonville, FL 32246 | 2019-04-10 |
| 1780173526 | Jules Novall LLC | Taxi | 4600 Touchton Rd, Jacksonville, FL 32246 | 2018-05-08 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1952770463 | Alignment Healthcare Florida LLC | Clinic/Center | 3520-1 St. Johns Bluff Rd., Jacksonville, FL 32246 | 2015-09-15 |
| 1558739417 | Jessica Brake | Physical Therapist | 9726 Touchton Road, Suite 104, Jacksonville, FL 32246 | 2015-09-09 |
| 1043686256 | Healthyeye Dba Vision Express LLC | Optometrist | 4871 Town Center Parkway #5, Jacksonville, FL 32246 | 2015-08-12 |
| 1477954675 | Joanivette Rodriguez | Psychologist | 3451 Saland Way Apt 504, Jacksonville, FL 32246 | 2014-09-08 |
| Find all providers in zip 32246 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676186 | Sarah Colleen Tapscott | Family Medicine | 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 | 2020-07-20 |
| 1790303170 | Samantha L Scott | Family Medicine | 516 Pierce Ln, Jacksonville, TX 75766-4546 | 2020-07-11 |
| 1689298689 | Meridian Spine and Joint, Inc | Family Medicine | 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 | 2020-06-04 |
| 1154942563 | Families First Medical Group | Family Medicine | 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 | 2020-04-27 |
| 1598396392 | Pareto Population Health Management Practice Pllc | Family Medicine | 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 | 2020-01-30 |
| 1942862206 | Cindy S Wright Do Pllc | Family Medicine | 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 | 2019-07-07 |
| 1942868377 | Pain Spine & Wellness LLC | Family Medicine | 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 | 2019-05-31 |
| 1669035705 | Kathy Jo Daniels | Family Medicine | 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 | 2019-04-15 |
| 1821579103 | Tiffany N Major | Family Medicine | 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 | 2018-08-24 |
| 1568987360 | Main Street Health LLC | Family Medicine | 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 | 2017-08-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32246 |
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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.