Coastline Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTLINE PHYSICAL THERAPY LLC

Practice address

3781 S Nova Rd Ste B
Port Orange, FL 32129-4285

Phone

(770) 235-0071

NPI assigned

Mar 4, 2024

Organization subpart

No

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

Authorized official

Name

Mr. John Minella

Title

Owner

Phone

(770) 235-0071

Specialties & licenses 1

Addresses

Other names 1

• Fyzical Therapy & Balance Centers Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Kendra Louise Bloomer

  • Physical Therapist
  • Deland, FL
  • NPI 1831584465
  Medicare reassignment Care Compare group NPD
• Ute Stern-Ratzel, PT

  • Physical Therapist
  • Bradenton, FL
  • NPI 1053754432
  Medicare reassignment Care Compare group NPD
• Rhonda Pierce, P.T.

  • Physical Therapist
  • Lucedale, MS
  • NPI 1811105463

  FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1174380422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 HORTON ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321692920",
            "telephone_number": "770-235-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3781 S NOVA RD STE B",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294285",
            "telephone_number": "770-235-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "MINELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-235-0071",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy & Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Coastal Oaks Homecare Inc
• Coastline Family Medicine LLC
• Ronald Michael Coblentz
• Jason Thomas Coe, D.C.
• Antonio Coffa
• Cogent Healthcare of Jacksonville, LLC
• Harrison Max Cohane I, RBT

• Physical Therapist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.