Provider Demographics
NPI:1134310444
Name:COLEMAN, STEVEN P (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9200 BONITA BEACH RD SE
Mailing Address - Street 2:STE 113
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4278
Mailing Address - Country:US
Mailing Address - Phone:239-908-4711
Mailing Address - Fax:
Practice Address - Street 1:9200 BONITA BEACH RD SE
Practice Address - Street 2:STE 113
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4278
Practice Address - Country:US
Practice Address - Phone:239-908-4711
Practice Address - Fax:941-315-8535
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9731207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE 24149Medicare UPIN