OrganizationCoastal Therapy & Learning Center, Inc.Speech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address2730 Isabella Blvd, Suite 10, Jacksonville Beach, FL 32250-8001(904) 372-4070PECOS EnrollmentBased on the most recent information from CMS, provider Coastal Therapy & Learning Center, Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1184711053Provider TypeOrganizationFull NameCoastal Therapy & Learning Center, Inc.SubpartNoEnumeration Date10/10/2006Last Updated7/27/2009Contact InformationPractice LocationPractice Address2730 Isabella Blvd, Suite 10, Jacksonville Beach, FL 32250-8001Phone(904) 372-4070Fax(904) 372-4075Mailing LocationMailing Address2730 Isabella Blvd, Suite 10, Jacksonville Beach, FL 32250-8001Phone(904) 372-4070Fax(904) 372-4075Authorized OfficialNameLotowycz, Nancy T. (Owner/Director)Phone(904) 372-4070Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseSA2176FloridaProvider IdentifiersIDDescriptionIssuerID888900700DescriptionMedicaidIssuerUnlistedFlorida