Provider Demographics
NPI:1881686608
Name:COASTAL NEPHROLOGY & HYPERTENSION CENTER PA
Entity Type:Organization
Organization Name:COASTAL NEPHROLOGY & HYPERTENSION CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABBAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RABIEI, MD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-253-8121
Mailing Address - Street 1:641 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 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:SUITE 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:2005-08-18
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84437207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3766903OtherAETNA NON HMO
FL11127OtherBLUE CROSS
FL2087096OtherFIRST HEALTH CCN NETWORK
FL264835OtherAMERIGROUP INS
FL7239688OtherAETNA BLUE BELL
FL3354249OtherCIGNA
FL263877100Medicaid
FL5885OtherAMERICAS HEALTH CHOICE
FL9308574OtherPHCS
FLH67857OtherVISTA HEALTH
FL2087096OtherFIRST HEALTH CCN NETWORK
FL3766903OtherAETNA NON HMO
FLK5954Medicare ID - Type UnspecifiedGROUP
FL263877100Medicaid