Coastalmdlive, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

COASTALMDLIVE, LLC

Practice address

913 Gulf Breeze Pkwy Ste 3
Gulf Breeze, FL 32561-4728

Phone

(850) 860-4679

NPI assigned

Feb 17, 2023

Organization subpart

No

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

Authorized official

Name

Randy Neil, MDNPI 1962898841

Title

Owner/Physician

Phone

(850) 860-4679

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Randy Neil, MD

  • Psychiatry Physician
  • Gulf Breeze, FL
  • NPI 1962898841
  NPD Authorized official

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1255039418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 GULF BREEZE PKWY STE 3",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614728",
            "telephone_number": "850-860-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 GULF BREEZE PKWY STE 3",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614728",
            "telephone_number": "850-860-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTALMDLIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "NEIL",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "850-860-4679",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Club2,LLC
• Coastal Kids Endocrinology and Weight Management LLC
• Coastal Medical Integration Inc
• Coastal Pain Management PLLC
• Coastal Wound Care Specialist LLC
• Larissa Coffey
• Shelly Lynn Cohn, FNP-BC
• Coleman Orthopaedic LLC
• Alexander Chisolm Coleman, M.D.
• Anne-Marie Collins, MS, LMHC, ATR

• Psychiatry Physician in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.