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General NPI Number Information
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NPI Number | 1497043269
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Entity Type | Organization
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Legal Business Name | ANTON COLEMAN, MUNCH E. BACKEN, PA
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 3202 SERENITY CT #102
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City | NAPLES
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State | FL
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Zip | 34114-9576
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Country | US
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Telephone | 405-406-2222
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Fax | 239-498-3262
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Provider Business Mailing Address
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Address Line | PO BOX 7518
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City | FORT MYERS
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State | FL
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Zip | 33911-7518
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTON COLEMAN
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Credential | M.D.
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Telephone | 405-406-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME98598
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License Number State | FL
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