Healthcare Provider Details

I. General information

NPI: 1710686134
Provider Name (Legal Business Name): LOLONA N COLEMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2023
Last Update Date: 02/24/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 BROYLES DR SE
PALM BAY FL
32909-2353
US

IV. Provider business mailing address

304 BROYLES DR SE
PALM BAY FL
32909-2353
US

V. Phone/Fax

Practice location:
  • Phone: 727-846-2469
  • Fax:
Mailing address:
  • Phone: 727-846-2469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9471872
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9471872
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN9471872
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License NumberRN9471872
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN9471872
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberRN9471872
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberRN9471872
License Number StateFL
# 8
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9471872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: