Charlotte L Coleman, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9102024 Issued in FL

Practice address

1061 Medical Center Dr
Suite 110
Orange City, FL 32763-8200

Phone

(386) 774-1223

Fax

(386) 774-4658

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1295785673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 MEDICAL CENTER DR",
            "address_2": "SUITE 110",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638200",
            "telephone_number": "386-774-1223",
            "fax_number": "386-774-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 MEDICAL CENTER DR",
            "address_2": "SUITE 110",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638200",
            "telephone_number": "386-774-1223",
            "fax_number": "386-774-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CHARLOTTE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291392500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Code Blew Healthcare Services LLC
• Laura Coe, LMHC
• Linda Coetzee, P.T.
• Eric A Cohn, D.O.
• Craig N Cole, M.D.
• Robert Patrick Collette, M.D.
• Karla M. Colon Lebron, RN
• Amialys Colon Negron
• Melissa Colon
• Comfortable Care Dental Health Professionals, P.a.

• Medical Physician Assistant in Orange City, FL
• Providers in Orange City, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.