Provider Demographics
NPI:1417348830
Name:COYLE INSTITUTE FOR FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY
Entity Type:Organization
Organization Name:COYLE INSTITUTE FOR FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-983-3528
Mailing Address - Street 1:9295 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-8055
Mailing Address - Country:US
Mailing Address - Phone:850-983-3528
Mailing Address - Fax:850-983-3546
Practice Address - Street 1:9295 SCENIC HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-8055
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:2015-02-06
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9063261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269991500Medicaid
FL00A6DOtherBCBSFL