Provider Demographics
NPI:1184801094
Name:COASTAL IMAGING SOLUTIONS
Entity type:Organization
Organization Name:COASTAL IMAGING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEVILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMCHANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-671-4882
Mailing Address - Street 1:806 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-7851
Mailing Address - Country:US
Mailing Address - Phone:386-671-4882
Mailing Address - Fax:386-671-0084
Practice Address - Street 1:806 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-7851
Practice Address - Country:US
Practice Address - Phone:386-671-4882
Practice Address - Fax:386-671-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076138261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology