| NPI | 1902970684 |
|---|---|
| Former Legal Business Name | COASTAL CARE MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CLINT D MILLER President 904-642-3304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2016-01-06 |