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General NPI Number Information
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NPI Number | 1801077664
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Entity Type | Individual
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Provider Name | CAMERON COGHILL PT
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Gender | Male
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 1303 N TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34236-2432
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Country | US
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Telephone | 941-953-6949
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Fax | 941-954-5827
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Provider Business Mailing Address
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Address Line | 5050 CENTRAL SARASOTA PKWY APT 305
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City | SARASOTA
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State | FL
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Zip | 34238-7604
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Country | US
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Telephone | 941-250-5559
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34681
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License Number State | FL
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