OrganizationActive
Coastal Family Practice LLC
NPI 1275552358 · Family Medicine Physician · Edgewater, FL
Provider details
- NPI number
- 1275552358
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Pam Lacey, Practice Manager(386) 761-6044
- License
- L800015935 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1404 S Ridgewood Ave
Edgewater, FL 32132-2720
Phone: (386) 426-8166
Fax: (386) 426-6399
Street-level locationGet directions
Mailing address
1404 S Ridgewood Ave
Edgewater, FL 32132-2720
Registry dates
- Enumerated
- 2006-07-19
- Last updated
- 2009-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.