Healthcare Provider Details

I. General information

NPI: 1710047451
Provider Name (Legal Business Name): STEPHANIE R. COATES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 COUNTY ROAD 1
DUNEDIN FL
34698-4610
US

IV. Provider business mailing address

1228 COUNTY ROAD 1
DUNEDIN FL
34698-4610
US

V. Phone/Fax

Practice location:
  • Phone: 727-733-0443
  • Fax: 727-733-0444
Mailing address:
  • Phone: 727-733-0443
  • Fax: 727-733-0444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC3880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: