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NPI Code Detail

MEDICARE: DR. MAE M COLEMAN MD

MEDICARE: DR. MAE M COLEMAN MD
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
12080N0001XNeonatal-Perinatal Medicine PhysicianME85070FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235195272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAE M COLEMAN MD
Provider Business Mailing Address
First Line : 1500 CONCORD TER
Second Line :
City : SUNRISE
State : FL
Zip : 33323-2815
Country : US
Telephone Number : 800-243-3839
Fax Number : 954-858-0404
Provider Business Practice Location Address
First Line : 4201 BELFORT RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-1431
Country : US
Telephone Number : 904-296-3700
Fax Number : 954-858-0404
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 06/09/2014

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