Coastal Medical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1114 Issued in FL

Legal business name

COASTAL MEDICAL CENTER LLC

Practice address

1 S School Ave
Suite 103
Sarasota, FL 34237-6014

Phone

(941) 308-8500

Fax

(941) 308-8501

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William G Jackson

Title

Executive Director

Phone

(941) 309-7006

Specialties & licenses 1

Addresses

Listed as

Coastal Medical Center LLCCCN 10C0001343

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1538231956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S SCHOOL AVE",
            "address_2": "SUITE 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342376014",
            "telephone_number": "941-308-8500",
            "fax_number": "941-308-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S SCHOOL AVE",
            "address_2": "SUITE 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342376014",
            "telephone_number": "941-308-8500",
            "fax_number": "941-308-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "941-309-7006",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coast Consulting, LLC.
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• Coastal Behavioral Healthcare, Inc.
• Coastal in Home Senior Care
• Coastal Pain Physicians
• Loary Viola Coates, MENTAL HEALTH COUNSE
• Marion Lee Coats, M.D.
• Tullio L. Coccia, M.D.
• James Robert Cocco, MD

• Ambulatory Surgical Clinic/Center in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.