Coastal Surgical Services LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

COASTAL SURGICAL SERVICES LLC

Practice address

48 Fort Royal Is
Ft Lauderdale, FL 33308-6014

Phone

(321) 626-9794

NPI assigned

May 10, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Bradford Angiulli, PA-CNPI 1013194372

Title

Manager

Phone

(321) 626-9794

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradford Christian Angiulli, PA-C

  • Physician Assistant
  • Orlando, FL
  • NPI 1013194372
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1144910423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 FORT ROYAL IS",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086014",
            "telephone_number": "321-626-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 FORT ROYAL IS",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086014",
            "telephone_number": "321-626-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SURGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "ANGIULLI",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-626-9794",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.