Provider Demographics
NPI:1699901504
Name:COASTAL ENDOCRINOLOGY LLC
Entity type:Organization
Organization Name:COASTAL ENDOCRINOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:R
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-301-1692
Mailing Address - Street 1:2046 TREASURE COAST PLZ STE A-356
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-0927
Mailing Address - Country:US
Mailing Address - Phone:321-301-1692
Mailing Address - Fax:
Practice Address - Street 1:1019 HARVIN WAY STE 120
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3286
Practice Address - Country:US
Practice Address - Phone:321-301-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90073207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43242OtherBCBS
FLBU177AMedicare PIN