Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coast Multi-Specialty Medical Group PA

Organization Procedural Dermatology Physician · NPI 1306971833

Coast Multi-Specialty Medical Group PA is a Procedural Dermatology Physician in Lake City, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

480 SW Main Blvd
Lake City, FL 32025-5269
Phone: (386) 758-1965
Fax: (386) 758-6923
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X · Licence ME80264 (FL)

Record details

NPI number1306971833
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official J. Trott — President · (386) 758-1965
Other names Cmsmg
NPI enumeratedFebruary 23, 2007
Last updated in NPPESDecember 23, 2014
Mailing addressPo Box 1762, Lake City, FL 32056-1762