Provider Demographics
NPI:1437565678
Name:COFFEY, MADELINE (AUD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:
Last Name:COFFEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 CONCOURSE PKWY S
Mailing Address - Street 2:STE. 110
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6114
Mailing Address - Country:US
Mailing Address - Phone:407-253-1000
Mailing Address - Fax:321-397-0000
Practice Address - Street 1:790 CONCOURSE PKWY S
Practice Address - Street 2:STE. 110
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6114
Practice Address - Country:US
Practice Address - Phone:407-253-1000
Practice Address - Fax:321-397-0000
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1878231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist