Provider Demographics
NPI:1083957732
Name:COASTAL INTERNAL MEDICINE OF JUPITER, PA
Entity Type:Organization
Organization Name:COASTAL INTERNAL MEDICINE OF JUPITER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABBAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RABIEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-253-8121
Mailing Address - Street 1:641 UNIVERSITY BLVD
Mailing Address - Street 2:STE 211
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2791
Mailing Address - Country:US
Mailing Address - Phone:561-253-8121
Mailing Address - Fax:561-253-8021
Practice Address - Street 1:641 UNIVERSITY BLVD
Practice Address - Street 2:STE 211
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2791
Practice Address - Country:US
Practice Address - Phone:561-253-8121
Practice Address - Fax:561-253-8021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty