Basic Information
| Provider Information | |||||||||
| NPI: | 1609860170 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COYLE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 SCENIC DR | ||||||||
| Address2: | SENIOR FRIENDSHIP CENTERS, INC. | ||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342931510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415840043 | ||||||||
| FaxNumber: | 9414968627 | ||||||||
| Practice Location | |||||||||
| Address1: | 2350 SCENIC DR | ||||||||
| Address2: | SENIOR FRIENDSHIP CENTERS, INC. | ||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342931510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415840043 | ||||||||
| FaxNumber: | 9414968627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME76961 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.