Provider Demographics
NPI:1558850198
Name:COLEMAN, MARIE ELDA (RT10762)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:ELDA
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RT10762
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 COTTON BAY DR W APT 1102
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-9055
Mailing Address - Country:US
Mailing Address - Phone:561-260-9239
Mailing Address - Fax:
Practice Address - Street 1:779 COTTON BAY DR W APT 1102
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-9055
Practice Address - Country:US
Practice Address - Phone:561-260-9239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT10762227900000X
FLRT1107622278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered