| NPI | 1962831883 |
|---|---|
| Former Legal Business Name | COASTAL CARDIOVASCULAR & THORACIC ASSOCIATES, P.A. |
| Entity Type | Organization |
| Authorized Contact | WILLIAM HAMPTON JOHNSON Operating Manager 386-672-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME36700) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME58979) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME58979) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME36700) | |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2016-01-08 |