Provider Demographics
NPI:1295805638
Name:GULFCOAST CARDIOLOGY GROUP
Entity type:Organization
Organization Name:GULFCOAST CARDIOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-890-8004
Mailing Address - Street 1:610 STRICKLAND DR
Mailing Address - Street 2:STE 370
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-4786
Mailing Address - Country:US
Mailing Address - Phone:409-963-0000
Mailing Address - Fax:409-963-1899
Practice Address - Street 1:610 STRICKLAND DR
Practice Address - Street 2:STE 370
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-4786
Practice Address - Country:US
Practice Address - Phone:409-963-0000
Practice Address - Fax:409-963-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty