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General NPI Number Information
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NPI Number | 1649347147
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Entity Type | Individual
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Provider Name | MARY ANN FRANCES COATOAM PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 303 N CLYDE MORRIS BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2709
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Country | US
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Telephone | 386-425-4100
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Fax | 386-258-4875
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Provider Business Mailing Address
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Address Line | PO BOX 22266
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City | BELFAST
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State | ME
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Zip | 04915-4473
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Country | US
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Telephone | 386-226-4590
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Fax | 386-226-4577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 9102357
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9102357
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License Number State | FL
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