Provider Demographics
NPI:1518302231
Name:PULIDO COATES AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:PULIDO COATES AND ASSOCIATES LLC
Other - Org Name:CLINICAL AND FAMILY THERAPY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LMFT, LPC
Authorized Official - Phone:813-508-1859
Mailing Address - Street 1:4520 W OAKELLAR AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3114
Mailing Address - Country:US
Mailing Address - Phone:813-883-0162
Mailing Address - Fax:888-850-1859
Practice Address - Street 1:3005 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8954
Practice Address - Country:US
Practice Address - Phone:813-833-0162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PULIDO COATES AND ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP2500X
FLARNP1570142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001386800Medicaid
FLP00865875OtherRAILROAD MEDICARE
FLCD280ZMedicare PIN