Individual
MR. JOHN FRANCIS COUGHLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
4550 EXECUTIVE DR, SUITE 104, NAPLES, FL 34119-8805
(239) 217-4434
(239) 217-4436
Mailing address
6910 CORKSCREW LANE, NAPLES, FL 34120
(239) 595-7667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102717
FL
363AM0700X
Medical Physician Assistant
PA9102717
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292945700
—
FL
Enumeration date
05/15/2007
Last updated
04/14/2010
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