Provider Demographics
NPI:1497238091
Name:COASTAL VEIN AND VASCULAR SPECIALISTS, INC
Entity Type:Organization
Organization Name:COASTAL VEIN AND VASCULAR SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BOYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-295-4110
Mailing Address - Street 1:3401 PGA BLVD STE 325
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2898
Mailing Address - Country:US
Mailing Address - Phone:561-295-4110
Mailing Address - Fax:
Practice Address - Street 1:3401 PGA BLVD STE 325
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2898
Practice Address - Country:US
Practice Address - Phone:718-974-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty