OrganizationActive
Coast Multi-Specialty Medical Group P.A
NPI 1306971833 · Procedural Dermatology Physician · Lake City, FL
Provider details
- NPI number
- 1306971833
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- J. Trott, President
- License
- ME80264 (FL)
Practice location
480 Sw Main Blvd
Lake City, FL 32025-5269
Phone: (386) 758-1965
Fax: (386) 758-6923
Mailing address
Po Box 1762
Lake City, FL 32056-1762
Registry dates
- Enumerated
- 2007-02-23
- Last updated
- 2014-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.