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Individual

COLETTE SUSAN HAYWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3415 LEE BLVD, LEHIGH ACRES, FL 33971-1576
(239) 344-2305
(239) 368-2044
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME108878
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003559400
FL
01
14CS6
BCBS
FL
Enumeration date
01/12/2011
Last updated
10/16/2020
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