Provider Demographics
NPI:1427111657
Name:U.S. COAST GUARD
Entity type:Organization
Organization Name:U.S. COAST GUARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH SERVICES TECH
Authorized Official - Phone:305-535-4525
Mailing Address - Street 1:100 MACARTHUR CSWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-5101
Mailing Address - Country:US
Mailing Address - Phone:305-535-4350
Mailing Address - Fax:305-535-4351
Practice Address - Street 1:100 MACARTHUR CSWY
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5101
Practice Address - Country:US
Practice Address - Phone:305-535-4350
Practice Address - Fax:305-535-4351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service