Provider Demographics
NPI:1194106385
Name:COASTAL CARDIOVASCULAR CONSULTANTS PLLC
Entity type:Organization
Organization Name:COASTAL CARDIOVASCULAR CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:S
Authorized Official - Last Name:KRISHNAMURTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-752-2840
Mailing Address - Street 1:3904 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3111
Mailing Address - Country:US
Mailing Address - Phone:941-752-2840
Mailing Address - Fax:855-253-4836
Practice Address - Street 1:3904 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3111
Practice Address - Country:US
Practice Address - Phone:941-752-2840
Practice Address - Fax:941-345-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty