Provider Demographics
NPI:1588906176
Name:COASTAL HEALTH SPECIALISTS
Entity type:Organization
Organization Name:COASTAL HEALTH SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:863-647-5700
Mailing Address - Street 1:2210 FRONT ST
Mailing Address - Street 2:SUITE 104B
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-7360
Mailing Address - Country:US
Mailing Address - Phone:863-647-5700
Mailing Address - Fax:863-647-5711
Practice Address - Street 1:2210 FRONT ST
Practice Address - Street 2:SUITE 104B
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-7360
Practice Address - Country:US
Practice Address - Phone:863-647-5700
Practice Address - Fax:863-647-5711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054874174400000X
FLAY1203231H00000X
FLME47652174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty