Provider Demographics
NPI:1558391474
Name:COASTAL PULMONARY & CRITICAL CARE PLC
Entity type:Organization
Organization Name:COASTAL PULMONARY & CRITICAL CARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-822-6661
Mailing Address - Street 1:1201 FIFTH AVE NORTH
Mailing Address - Street 2:#206
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707
Mailing Address - Country:US
Mailing Address - Phone:727-822-6661
Mailing Address - Fax:727-823-1334
Practice Address - Street 1:1201 FIFTH AVE NORTH
Practice Address - Street 2:#206
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707
Practice Address - Country:US
Practice Address - Phone:727-822-6661
Practice Address - Fax:727-823-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9043Medicare ID - Type UnspecifiedGROUP NUMBER