Individual
MR. JOHN PATRICK COUGHLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12220 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9201
(813) 631-5034
(813) 631-5061
Mailing address
12220 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9201
(813) 631-5034
(813) 631-5061
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
ME67720
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264225500
—
FL
Enumeration date
07/07/2006
Last updated
08/02/2021
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