Individual
BENJAMIN C COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
711 E OAK ST, KISSIMMEE, FL 34744-4573
(407) 933-1500
(407) 933-1503
Mailing address
PO BOX 2820, WINDERMERE, FL 34786-2820
(407) 933-1500
(407) 933-1503
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA54981
FL
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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