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Individual

ROBERTO P COQUIS SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2161 E COMMERCIAL BLVD, 2ND FLOOR, FORT LAUDERDALE, FL 33308-3810
(954) 491-5187
(954) 491-5217
Mailing address
2161 E COMMERCIAL BLVD, 2ND FLOOR, FORT LAUDERDALE, FL 33308-3810
(954) 491-5187
(954) 491-5217

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0027643
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
057490200
FL
Enumeration date
05/12/2006
Last updated
07/16/2010
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