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COASTAL FAMILY PRACTICE LLC
NPI 1275552358
Family Medicine in Edgewater, FL

Active since July 19, 2006CLIA 10D0943201 · Waiver
1404 S RIDGEWOOD AVE, EDGEWATER, FL 32132(386) 426-8166(386) 426-6399 Get Directions Write a Review

NPPES record last updated: November 9, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Coastal Family Practice Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL FAMILY PRACTICE LLC (NPI 1275552358) is a healthcare organization registered as a family medicine in Edgewater, Florida and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 21, 2028 and lists Pam Lacey, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1275552358
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCOASTAL FAMILY PRACTICE LLC
Location Address1404 S RIDGEWOOD AVEEdgewater, FL 32132-2720
Mailing Address1404 S Ridgewood AveEdgewater, FL 32132-2720 · (386) 426-8166 · Fax (386) 426-6399
Phone(386) 426-8166
Fax(386) 426-6399
Organization SubpartNo
Authorized OfficialPam LaceyPractice Manager · (386) 761-6044
Enumeration DateJuly 19, 2006
Last NPPES UpdateNovember 9, 2009
✔ NPI 1275552358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · L800015935
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1404 S RIDGEWOOD AVE, Edgewater, FL 32132
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0943201

Coastal Family Practice · Edgewater, FL
Active · expires Apr 21, 2028
CLIA Number10D0943201
Laboratory TypePhysician Office
Certificate Effective DateApril 22, 2026
Certificate Expiration DateApril 21, 2028
Laboratory DirectorMargaret M. Chang
Laboratory Phone(386) 426-8166
Laboratory LocationCoastal Family Practice1404 S Ridgewood Ave, Edgewater, FL 32132
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SURYA PRAKASH RAO MD
Internal Medicine (Cardiovascular Disease)
1404 S RIDGEWOOD AVE
EDGEWATER, FL 32132
Volusia County (386) 258-8722
DR. MARGARET CHANG MD
Family Medicine
1404 S RIDGEWOOD AVE
EDGEWATER, FL 32132
Volusia County (386) 424-5777
DR. PATRICIA FREDETTE-HUFFMAN MD
Family Medicine
1404 S RIDGEWOOD AVE
EDGEWATER, FL 32132
Volusia County (386) 426-8166
LEWIS & KLANCKE CARDIOLOGY, P.A.
Internal Medicine (Cardiovascular Disease)
1404 S RIDGEWOOD AVE
EDGEWATER, FL 32132
Volusia County (386) 265-5926
MRS. SHELLY LYNN FRADET PA-C
Physician Assistant
1404 S RIDGEWOOD AVE
EDGEWATER, FL 32132
Volusia County (386) 426-8166

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Family Practice LLC's NPI number?

The NPI number for Coastal Family Practice LLC is 1275552358. It was assigned to this organization in the NPPES registry on July 19, 2006.

Where is Coastal Family Practice LLC located?

Coastal Family Practice LLC is located at 1404 S Ridgewood Ave, Edgewater, FL 32132. The listed phone number is (386) 426-8166.

What is Coastal Family Practice LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Coastal Family Practice LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0943201) is associated with this NPI, valid through April 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Coastal Family Practice LLC accept?

Health plans from Florida Blue HMO (a BlueCross BlueShield FL company) list Coastal Family Practice LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Coastal Family Practice LLC was last updated on November 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.