MEDICARE: DAVID COFER AUDIOLOGIST

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	237600000X	Audiologist-Hearing Aid Fitter	AY1459	FL

General Provider Information

NPI Number	:	1740652502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID COFER AUDIOLOGIST

Provider Business Mailing Address
First Line	:	1419 VISCAYA PKWY
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-6206
Country	:	US
Telephone Number	:	239-936-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	1419 VISCAYA PKWY
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-6206
Country	:	US
Telephone Number	:	239-936-1616
Fax Number	:

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

Provider Enumeration Date	:	10/20/2015
Last Update Date	:	10/20/2015

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