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Individual

ALEXANDER D COUGHLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3461 LITHIA PINECREST RD, VALRICO, FL 33596-6302
(813) 662-9718
Mailing address
5705 1/2 N SEMINOLE AVE, TAMPA, FL 33604-7053
(813) 516-9143

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PSI41782
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSI41782
FLORIDA DEPT OF HEALTH / BOARD OF PHARMACY
FL
Enumeration date
09/23/2022
Last updated
09/23/2022
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