Individual
DR. BRANDON LUCAS COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12432 DAVIE CT, VENICE, FL 34293-5789
(423) 215-1485
Mailing address
12432 DAVIE CT, VENICE, FL 34293-5789
(423) 215-1485
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2651
TN
207R00000X
Internal Medicine Physician
2651
TN
207R00000X
Internal Medicine Physician
Primary
OS16524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105941700
—
FL
01
—
M1092
MEDICARE
FL
Enumeration date
03/02/2012
Last updated
04/18/2025
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