Provider Demographics
NPI:1386975092
Name:COFFEY, GEORGE NELSON III (D,C)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:NELSON
Last Name:COFFEY
Suffix:III
Gender:M
Credentials:D,C
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:COFFEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2700 S TAMIAMI TRL
Mailing Address - Street 2:STE. 17
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-4530
Mailing Address - Country:US
Mailing Address - Phone:941-366-7111
Mailing Address - Fax:941-366-9812
Practice Address - Street 1:2700 S TAMIAMI TRL
Practice Address - Street 2:STE. 17
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-4530
Practice Address - Country:US
Practice Address - Phone:941-366-7111
Practice Address - Fax:941-366-9812
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor