Individual
ANTOINE COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
709 S 5TH ST, FORT PIERCE, FL 34950-8339
(772) 380-2327
Mailing address
709 S 5TH ST, FORT PIERCE, FL 34950-8339
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
PN5170659
FL
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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