Coast Pain Relief Center

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

ME 62002 Issued in FL

Legal business name

COAST PAIN RELIEF CENTER

Practice address

3233 SW Port St Lucie Blvd
Port St Lucie, FL 34953-3490

Phone

(772) 873-5552

Fax

(772) 873-5747

NPI assigned

Feb 4, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lindsay Nicole Petty

Title

Office Manager

Phone

(772) 873-5552

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1033357694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 SW PORT ST. LUCIE BLVD",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "349533490",
            "telephone_number": "772-873-5552",
            "fax_number": "772-873-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349533490",
            "telephone_number": "772-873-5552",
            "fax_number": "772-873-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST PAIN RELIEF CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "772-873-5552",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME 62002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Matthew Cliney, RDH
• Clover Pharmacy Inc
• Alexandra Marie Clyne
• Coast Care Partners LLC
• Coast Dental P.a. (Coast Dental-St. Lucie West)
• Coastal Care and Wellness PLLC
• Coastal Care Corporation (Cleveland Clinic Imaging)
• Coastal Care Corporation
• Coastal Care Corporation (Martin Memorial Medicenter at St Lucie West)
• Coastal Family Chiropractic PA

• Medical Specialty Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.