Individual
MRS. BAKEISHA PAYTON COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
590 ROB ROY DR, CLERMONT, FL 34711-2463
(863) 899-8004
(866) 728-9641
Mailing address
PO BOX 7293, LAKELAND, FL 33807-7293
(863) 899-8004
(866) 728-9641
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
689116196
FL
171M00000X
Case Manager/Care Coordinator
689116198
FL
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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