Individual
MS. MARY ANN FRANCES COATOAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 425-4100
(386) 258-4875
Mailing address
PO BOX 22266, BELFAST, ME 04915-4473
(386) 226-4590
(386) 226-4577
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9102357
FL
363AM0700X
Medical Physician Assistant
Primary
PA9102357
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291742400
—
FL
Enumeration date
11/29/2006
Last updated
01/27/2022
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