Provider Demographics
NPI:1700080165
Name:LYNDA COGGINS CRNA P A
Entity Type:Organization
Organization Name:LYNDA COGGINS CRNA P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:COGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:813-610-7751
Mailing Address - Street 1:3721 VILLAGE ESTATES PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4620
Mailing Address - Country:US
Mailing Address - Phone:813-610-7751
Mailing Address - Fax:813-383-8215
Practice Address - Street 1:2821 PROCTOR RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6443
Practice Address - Country:US
Practice Address - Phone:941-870-1872
Practice Address - Fax:941-870-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1603402367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty