Coastal Pediatric Group

Organization Active NPI Pediatrics Physician · Destin, FL

NPI 1417304643 · NPPES record last updated Jan 2, 2019

Key facts

NPI
1417304643
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
License
ME87333 (FL)
Legal business name
COASTAL PEDIATRIC GROUP
Practice address
36468 Emerald Coast Pkwy Unit 2101
Destin, FL 32541
Phone
(850) 659-6556
Fax
(850) 249-1308
NPI assigned
May 17, 2016
Organization subpart
No

Authorized official

Name
Marilyn T Sprenkle, MD
Title
Owner
Phone
(850) 659-6556

Practitioners 3

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

National Provider Directory

Locations

36468 Emerald Coast Pkwy
Ste 2101
Destin, FL 32541
Phone (850) 269-2186

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14223/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208000000X ME87333 FL Yes

Addresses

Primary practice location

36468 Emerald Coast Pkwy Unit 2101
Destin, FL 32541

Mailing address

36468 Emerald Coast Pkwy Unit 2101
Destin, FL 32541
Phone (850) 659-6556

Other providers in Destin, FL

All providers in Destin, FL · Pediatrics Physician in Florida

Sources for this page

Verify at the official NPI Registry.