COAST PORT CHARLOTTE, P.L.
NPI: 1164513230
· TAMPA, FL 33607
· Dentist
· NPI assigned 09/27/2006
$571.29
Total Medicaid Paid
Provider Details
| Authorized Official | FINNELL, DARLENE (DIRECTOR OF INS. AND CREDENTIALING) |
| NPI Enumeration Date | 09/27/2006 |
Related Entities
Other providers sharing the same authorized official: FINNELL, DARLENE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
24 |
$571.29 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
12 |
12 |
$571.29 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |