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General NPI Number Information
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NPI Number | 1679463343
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Entity Type | Individual
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Provider Name | XIOMARA ELISA COFFMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 07/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 385 WAYMONT CT
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City | LAKE MARY
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State | FL
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Zip | 32746-3574
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Country | US
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Telephone | 407-605-2185
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Fax |
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Provider Business Mailing Address
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Address Line | 13196 SW 106TH ST
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City | DUNNELLON
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State | FL
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Zip | 34432-5016
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Country | US
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Telephone | 352-454-7599
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11040864
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 9565105
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License Number State | FL
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