Provider Demographics
NPI:1164419768
Name:PROGRESSIVE WOMENS HEALTH PA
Entity Type:Organization
Organization Name:PROGRESSIVE WOMENS HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:850-983-3528
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32572-0591
Mailing Address - Country:US
Mailing Address - Phone:850-983-3528
Mailing Address - Fax:850-983-3546
Practice Address - Street 1:6072 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-5072
Practice Address - Country:US
Practice Address - Phone:850-983-3528
Practice Address - Fax:850-983-3546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9063207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND NPI 1548268246OtherDR. MICHAEL COYLE
FLK6277Medicare ID - Type Unspecified
IND NPI 1548268246OtherDR. MICHAEL COYLE