# PHYSICAL MEDICINE AND REHABILITATION, PA

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

## Provider details

- **NPI number:** 1437343795
- **Authorized official:** MR. ROBERT COOLIDGE (AGENT/REPRESENTATIVE)
- **Authorized official phone:** (386) 774-5211

## Contact information

- **Practice address:** 1133 SAXON BLVD, ORANGE CITY, FL 32763-8470
- **Practice address phone:** (386) 775-7080
- **Practice address fax:** (386) 775-8070
- **Mailing address:** PO BOX 741240, ORANGE CITY, FL 32774-1240
- **Mailing address phone:** (386) 774-5211
- **Mailing address fax:** (386) 774-5251

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | ME95874 | FL | Yes |

## Other

- **Enumeration date:** 08/30/2007
- **Last updated:** 03/26/2009