Provider Demographics
NPI:1841096476
Name:COASTAL RHEUMATOLOGY
Entity type:Organization
Organization Name:COASTAL RHEUMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSSINESS DEVELOPEMENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGUIRISTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-394-3063
Mailing Address - Street 1:3800 JOHNSON ST STE D
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6052
Mailing Address - Country:US
Mailing Address - Phone:954-237-3000
Mailing Address - Fax:
Practice Address - Street 1:5511 S CONGRESS AVE STE 115
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1140
Practice Address - Country:US
Practice Address - Phone:954-237-3000
Practice Address - Fax:954-837-9299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COASTAL RHEUMATOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Single Specialty