Healthcare Provider Details

I. General information

NPI: 1538092747
Provider Name (Legal Business Name): MAGDA K COIMIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 NW 74TH WAY
HOLLYWOOD FL
33024-1064
US

IV. Provider business mailing address

1890 NW 74TH WAY
HOLLYWOOD FL
33024-1064
US

V. Phone/Fax

Practice location:
  • Phone: 786-487-5655
  • Fax:
Mailing address:
  • Phone: 786-487-5655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN9218437
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: