Provider Demographics
NPI:1437362167
Name:COASTAL SPINE SPECIALISTS
Entity type:Organization
Organization Name:COASTAL SPINE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-548-4880
Mailing Address - Street 1:7800 66TH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2168
Mailing Address - Country:US
Mailing Address - Phone:727-548-4880
Mailing Address - Fax:
Practice Address - Street 1:7800 66TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2168
Practice Address - Country:US
Practice Address - Phone:727-548-4880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054576207XS0117X
FLPA9101640363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10618ZMedicare ID - Type UnspecifiedPAUL ZAK, MD
FLK4632Medicare ID - Type UnspecifiedGROUP NUMBER
FLE88423Medicare UPIN
FLP85243Medicare UPIN
FLU0433YMedicare ID - Type UnspecifiedKRISTEN RILEY, MPA