Mathematically speaking, it is true that Maxwell's equations by themselves aren't the whole story; they're a set of PDEs for which one needs to specify boundary conditions separately if one wants to solve them. Boundary conditions can be well-motivated from a physical perspective in a given scenario, but they do not follow from the equations themselves.
As for Poisson's equation versus Coulomb's Law, no requirement of spherical symmetry is necessary. Start with Poisson's equation, and set the charge density to be that of a point charge, namely \begin{align} \rho(\mathbf x) = q\delta(\mathbf x - \mathbf x_0). \end{align} Next, use the vanishing curl of the electric field so(which works in the absence of explicitly time-varying magnetic fields) to write $\mathbf E = -\nabla \Phi$ and plug this into Poisson's equation to obtain \begin{align} \nabla^2\Phi = -\frac{q}{\epsilon_0}\delta(\mathbf x-\mathbf x_0) \end{align} In other words, we want to determine $\Phi$ that is a Green's function for the Laplace equation. The general solution is \begin{align} \Phi = \frac{1}{4\pi\epsilon_0}\frac{q}{|\mathbf x - \mathbf x_0|} + F(\mathbf x) \end{align} where $F$ is a harmonic function, namely one which satisfies Laplace's equation. If we then invoke the boundary condition that the potential vanishes at infinity, then this forces $F$ to be identically zero, and we obtain \begin{align} \Phi = \frac{1}{4\pi\epsilon_0}\frac{q}{|\mathbf x - \mathbf x_0|} \end{align} which, upon taking the gradient, yields he electric field of a point charge which is essentially the content of Coulomb's Law.