Coastal Tides Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COASTAL TIDES SURGICAL CENTER, LLC

Practice address

1002 N Arnold Road
Suite 401
Panama City Beach, FL 32413

Phone

(850) 509-7567

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Daniel David Stannard, RN

Title

Administrator

Phone

(850) 509-7567

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Ambulatory surgical center certification: CCN 10C0001757

Legal name

COASTAL TIDES SURGICAL CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 25, 2025

Last certification

Feb 25, 2025

Facility address

1002 N Arnold Rd, STE 401
Panama City Beach, FL 32413

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1609616291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N ARNOLD RD UNIT 401",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324132524",
            "telephone_number": "448-212-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N ARNOLD ROAD",
            "address_2": "SUITE 401",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32413",
            "telephone_number": "850-509-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL TIDES SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "STANNARD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "850-509-7567",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Panama City Beach, FL
• Providers in Panama City Beach, 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 Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.