Provider Demographics
NPI:1073384228
Name:COASTAL RHEUMATOLOGY, LLC
Entity Type:Organization
Organization Name:COASTAL RHEUMATOLOGY, LLC
Other - Org Name:SOUTH FLORIDA RHEUMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BUSINESS DEVELOPEMENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGUIRISTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-394-3063
Mailing Address - Street 1:4700 SHERIDAN ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3416
Mailing Address - Country:US
Mailing Address - Phone:954-237-3000
Mailing Address - Fax:954-837-9299
Practice Address - Street 1:4331 N FEDERAL HWY STE 301
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5252
Practice Address - Country:US
Practice Address - Phone:954-237-3000
Practice Address - Fax:954-837-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty