Graduated: 1986
NPI: 1609901594
Practice Locations (4)
INTERCOASTAL MEDICAL GROUP INC
11505 RANGELAND PKWY
BRADENTON, FL 342114041
9419076016
INTERCOASTAL MEDICAL GROUP INC
921 S BENEVA RD
SARASOTA, FL 342322401
9413657390
INTERCOASTAL MEDICAL GROUP INC
965 S BENEVA RD
SARASOTA, FL 342322401
9413661888
LEGACY HEALTHCARE SERVICES INC
17470 BROOKSIDE TRACE CT
TAMPA, FL 336476201
8134435042
Source: CMS National Downloadable File, September 2026.