Provider Demographics
NPI:1902564479
Name:COGGINS, ASPEN ELIZABETH
Entity Type:Individual
Prefix:
First Name:ASPEN
Middle Name:ELIZABETH
Last Name:COGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 N COCOA BLVD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-7590
Mailing Address - Country:US
Mailing Address - Phone:321-735-9050
Mailing Address - Fax:321-735-9429
Practice Address - Street 1:840 N COCOA BLVD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7590
Practice Address - Country:US
Practice Address - Phone:321-735-9050
Practice Address - Fax:321-735-9429
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor