Coast Multi-Specialty Medical Group PA

Organization Procedural Dermatology Physician · NPI 1306971833

Coast Multi-Specialty Medical Group PA provides Procedural Dermatology Physician services in Lake City, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in: FL
In the registry since: 2007

What do these letters mean?

PA — Professional association: A form of business registration, not a clinical qualification.

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Practice location Address checks out

480 SW Main Blvd
Lake City, FL 32025-5269 Not confirmed with CMS for 11 years — call before visiting
Phone: (386) 758-1965
Fax: (386) 758-6923

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary)	Taxonomy 207NS0135X · Licence ME80264 (FL)

Record details

NPI number	1306971833
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	J. Trott — President · (386) 758-1965
Other names	Cmsmg
NPI enumerated	February 23, 2007
Last updated in NPPES	December 23, 2014
Mailing address	Po Box 1762, Lake City, FL 32056-1762