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General NPI Number Information
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NPI Number | 1215260534
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Entity Type | Organization
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Legal Business Name | MICHAEL A, COFFEY MD PA
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 2400 HARBOR BLVD SUITE 14
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5052
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Country | US
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Telephone | 941-766-4777
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Fax | 941-766-4778
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Provider Business Mailing Address
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Address Line | 2400 HARBOR BLVD SUITE 14
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5052
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Country | US
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Telephone | 941-766-4777
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Fax | 941-766-4778
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL COFFEY
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Credential | MD
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Telephone | 941-766-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME0052053
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License Number State | FL
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