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COASTAL CARE MEDICAL CENTER INC
NPI 1902970684
Family Medicine in Jacksonville, FL

Active since November 17, 2006
11761 BEACH BLVD, SUITE 8, JACKSONVILLE, FL 32246(904) 642-3304(904) 928-3561 Get Directions Write a Review

NPPES record last updated: January 6, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Coastal Care Medical Center Inc NPPES

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

COASTAL CARE MEDICAL CENTER INC (NPI 1902970684), doing business as Coastal Care Medical Center, is a healthcare organization registered as a family medicine in Jacksonville, Florida and active in the NPI registry since November 2006. The organization lists Clint D Miller, President, as its authorized official.

NPPES Registry Identity

NPI1902970684
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCOASTAL CARE MEDICAL CENTER INC
Location Address11761 BEACH BLVD, SUITE 8Jacksonville, FL 32246-6615
Mailing Address11761 Beach Blvd, Suite 8Jacksonville, FL 32246-6615 · (904) 642-3304 · Fax (904) 928-3561
Phone(904) 642-3304
Fax(904) 928-3561
Organization SubpartNo
Authorized OfficialClint D MillerPresident · (904) 642-3304
Enumeration DateNovember 17, 2006
Last NPPES UpdateJanuary 6, 2016
✔ NPI 1902970684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
11761 BEACH BLVD, Jacksonville, FL 32246
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Other Names 1

Former Legal Business NameCoastal Care Medical Center

Other Identifiers 2

Medicare NSC4625520001FL
Medicare ID-Type UnspecifiedK0340

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

Other Providers at the Same Location NPPES 4

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

MS. LAUREL ELIZABETH HERRON PA-C
Physician Assistant
11761 BEACH BLVD, UFJAX - ST. JOHNS BLUFF PRIMARY CARE
JACKSONVILLE, FL 32246
Duval County (904) 633-0585
CARMEN DANIELA RIZA ARNP
Nurse Practitioner (Adult Health)
11761 BEACH BLVD, STE 8
JACKSONVILLE, FL 32246
Duval County (904) 642-3304
COASTAL PLUS MEDICAL CENTER INC
Clinic/Center (Primary Care)
11761 BEACH BLVD, SUITE 8
JACKSONVILLE, FL 32246
Duval County (904) 642-3304
DR. CLINT D. MILLER D.C.
Chiropractor (Sports Physician)
11761 BEACH BLVD, SUITE 8
JACKSONVILLE, FL 32246
Duval County (904) 642-3304

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 Care Medical Center Inc's NPI number?

The NPI number for Coastal Care Medical Center Inc is 1902970684. It was assigned to this organization in the NPPES registry on November 17, 2006. The provider was formerly known as Coastal Care Medical Center.

Where is Coastal Care Medical Center Inc located?

Coastal Care Medical Center Inc is located at 11761 Beach Blvd Suite 8, Jacksonville, FL 32246. The listed phone number is (904) 642-3304.

What is Coastal Care Medical Center Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Coastal Care Medical Center Inc was last updated on January 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.