Provider Demographics
NPI:1780134601
Name:COET, ANDREW LEE (BCBA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:LEE
Last Name:COET
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 114TH AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5131
Mailing Address - Country:US
Mailing Address - Phone:727-410-6945
Mailing Address - Fax:
Practice Address - Street 1:6303 BLUE LAGOON DR STE 400
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-6040
Practice Address - Country:US
Practice Address - Phone:727-410-6945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL025005100Medicaid