Provider Demographics
NPI:1861420556
Name:COLEMAN, AUSTIN W (DO)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:W
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:10661 AIRPORT PULLING RD N
Mailing Address - Street 2:#12
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7335
Mailing Address - Country:US
Mailing Address - Phone:239-597-2792
Mailing Address - Fax:239-598-2748
Practice Address - Street 1:10661 AIRPORT PULLING RD N
Practice Address - Street 2:#12
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-7335
Practice Address - Country:US
Practice Address - Phone:239-597-2792
Practice Address - Fax:239-598-2748
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8806207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I09753Medicare UPIN
P00189763Medicare PIN
FL43141ZMedicare PIN