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NPI Code Detail

MEDICARE: MR. GREGORY MANUEL COYA PTA

MEDICARE:  MR. GREGORY MANUEL COYA  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant18401FL

General Provider Information

NPI Number : 1124595897
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY MANUEL COYA PTA
Provider Business Mailing Address
First Line : 4517 CLARKWOOD CT
Second Line :
City : LAND O LAKES
State : FL
Zip : 34639-4094
Country : US
Telephone Number : 813-310-4678
Fax Number : 813-996-2927
Provider Business Practice Location Address
First Line : 4517 CLARKWOOD CT
Second Line :
City : LAND O LAKES
State : FL
Zip : 34639-4094
Country : US
Telephone Number : 813-310-4678
Fax Number : 813-996-2927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2018
Last Update Date : 05/26/2026

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