1881686608 NPI number — COASTAL NEPHROLOGY & HYPERTENSION CENTER, PA

Table of content: MRS. TARA NICHOLE SNELGROVE PT, DPT (NPI 1033347067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881686608 NPI number — COASTAL NEPHROLOGY & HYPERTENSION CENTER, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COASTAL NEPHROLOGY & HYPERTENSION CENTER, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881686608
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
641 UNIVERSITY BLVD STE 211
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUPITER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33458-2794
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-253-8121
Provider Business Mailing Address Fax Number:
561-253-8021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
641 UNIVERSITY BLVD STE 211
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-2794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-253-8121
Provider Business Practice Location Address Fax Number:
561-253-8021
Provider Enumeration Date:
08/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RABIEI
Authorized Official First Name:
ABBAS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-253-8121

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  ME84437 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3766903 . This is a "AETNA NON HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 11127 . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2087096 . This is a "FIRST HEALTH CCN NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 264835 . This is a "AMERIGROUP INS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7239688 . This is a "AETNA BLUE BELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3354249 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 263877100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5885 . This is a "AMERICAS HEALTH CHOICE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 9308574 . This is a "PHCS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: H67857 . This is a "VISTA HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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