MEDICARE: STEVEN P COLEMAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OS9731	FL

General Provider Information

NPI Number	:	1134310444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN P COLEMAN D.O.

Provider Business Mailing Address
First Line	:	9200 BONITA BEACH RD SE
Second Line	:	STE 113
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-4278
Country	:	US
Telephone Number	:	239-908-4711
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 BONITA BEACH RD SE
Second Line	:	STE 113
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-4278
Country	:	US
Telephone Number	:	239-908-4711
Fax Number	:	941-315-8535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	08/30/2017

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