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

Coastal Esthetics, LLC

Organization Adult Medicine Physician · NPI 1114572245

Coastal Esthetics, LLC is an Adult Medicine Physician in Edgewater, Florida. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

109 W Knapp Ave
Edgewater, FL 32132-1555
Phone: (386) 957-4100
Fax: (386) 957-4104
Show map & directions

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

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X

Record details

NPI number1114572245
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carissa Peterson — Owner/Aprn · (386) 957-4100
Other names Coastline Primary Care; Coastline Primary Care
NPI enumeratedAugust 6, 2019
Last updated in NPPESApril 26, 2022
Certification dateApril 26, 2022
Mailing address109 W Knapp Ave, Edgewater, FL 32132-1555

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