Provider Demographics
NPI:1033410576
Name:FLORIDA COASTAL PLASTIC SUGERY
Entity Type:Organization
Organization Name:FLORIDA COASTAL PLASTIC SUGERY
Other - Org Name:FLORIDA PLASTIC SURGERY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-798-9777
Mailing Address - Street 1:5105 MANATEE AVE W
Mailing Address - Street 2:SUITE 19
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3715
Mailing Address - Country:US
Mailing Address - Phone:941-798-9777
Mailing Address - Fax:941-795-5177
Practice Address - Street 1:5105 MANATEE AVENUE WEST
Practice Address - Street 2:SUIT 19
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3715
Practice Address - Country:US
Practice Address - Phone:941-798-9777
Practice Address - Fax:941-795-5177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBIN HAMLIN. M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87555174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH90080Medicare UPIN