Provider Demographics
NPI:1245815430
Name:FIRST COAST MEDICINE PLLC
Entity type:Organization
Organization Name:FIRST COAST MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:646-872-3015
Mailing Address - Street 1:12574 FLAGLER CENTER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-2614
Mailing Address - Country:US
Mailing Address - Phone:646-872-3015
Mailing Address - Fax:
Practice Address - Street 1:12574 FLAGLER CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2614
Practice Address - Country:US
Practice Address - Phone:646-872-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty