Provider Demographics
NPI:1043446560
Name:COICOU, GLADYS
Entity Type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:
Last Name:COICOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 JAMAICA DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3550
Mailing Address - Country:US
Mailing Address - Phone:954-981-3216
Mailing Address - Fax:
Practice Address - Street 1:2331 JAMAICA DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-3550
Practice Address - Country:US
Practice Address - Phone:954-549-8861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL687536096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health