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COASTAL LONGEVITY LLC
NPI 1912576893
Clinic/Center - Health Service in Virginia Beach, VA

Active since June 23, 2021
3128 KLINE DR, VIRGINIA BEACH, VA 23452(804) 840-8522 Get Directions Write a Review

NPPES record last updated: June 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Coastal Longevity Llc NPPES

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

COASTAL LONGEVITY LLC (NPI 1912576893) is a healthcare organization registered as a health service in Virginia Beach, Virginia and active in the NPI registry since June 2021. The organization lists Michael Lucas Gambill, Ceo, as its authorized official.

NPPES Registry Identity

NPI1912576893
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameCOASTAL LONGEVITY LLC
Location Address3128 KLINE DRVirginia Beach, VA 23452-6226
Mailing Address3128 Kline DrVirginia Beach, VA 23452-6226 · (804) 840-8522
Phone(804) 840-8522
Organization SubpartNo
Authorized OfficialMichael Lucas GambillCeo · (804) 840-8522
Enumeration DateJune 23, 2021
NPPES CertifiedJune 23, 2021
✔ NPI 1912576893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
3128 KLINE DR, Virginia Beach, VA 23452
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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 Longevity LLC's NPI number?

The NPI number for Coastal Longevity LLC is 1912576893. It was assigned to this organization in the NPPES registry on June 23, 2021.

Where is Coastal Longevity LLC located?

Coastal Longevity LLC is located at 3128 Kline Dr, Virginia Beach, VA 23452. The listed phone number is (804) 840-8522.

What is Coastal Longevity LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Coastal Longevity LLC was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.