Provider Demographics
NPI:1225085715
Name:WEST COAST NEONATOLOGY, INC.
Entity Type:Organization
Organization Name:WEST COAST NEONATOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:SCHULHOF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-898-7451
Mailing Address - Street 1:PO BOX 946298
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-6298
Mailing Address - Country:US
Mailing Address - Phone:727-767-4378
Mailing Address - Fax:
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:5TH FLOOR
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-767-4313
Practice Address - Fax:727-767-4391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251391900Medicaid
FL251391901OtherRPICC GROUP NUMBER
FL251391908Medicaid
FL251391911Medicaid
FL251391912Medicaid
FL251391915Medicaid
FL39761OtherBC/BS GROUP NUMBER
FL251391905Medicaid
FL251391909Medicaid
FLCY392AOtherMEDICARE GROUP NUMBER
FL251391914Medicaid