# CORAL SPRINGS PHYSICAL MEDICINE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306256987
- **Authorized official:** ALIYAH STOTTER (OWNER)
- **Authorized official phone:** (954) 752-7373

## Contact information

- **Practice address:** 9720 W SAMPLE RD, CORAL SPRINGS, FL 33065-4004
- **Practice address phone:** (954) 752-7373
- **Practice address fax:** (954) 752-7351
- **Mailing address:** 9858 CLINT MOORE RD, C111-274, BOCA RATON, FL 33496-1034
- **Mailing address phone:** (561) 482-1144
- **Mailing address fax:** (561) 482-1145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | CH9519 | FL | Yes |

## Other

- **Enumeration date:** 05/05/2014
- **Last updated:** 06/13/2014