Provider Demographics
NPI:1912911942
Name:COLEMAN, HUGH AARON (DO)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:AARON
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MASON AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117
Mailing Address - Country:US
Mailing Address - Phone:386-366-3400
Mailing Address - Fax:386-274-1258
Practice Address - Street 1:1900 MASON AVENUE
Practice Address - Street 2:SUITE 140
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117
Practice Address - Country:US
Practice Address - Phone:386-671-2138
Practice Address - Fax:386-274-1258
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7503207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257934100Medicaid
FLE2247Medicare ID - Type Unspecified
FL257934100Medicaid
FL257934100Medicaid