Provider Demographics
NPI:1740355361
Name:COLEMAN, ARTHUR (PT)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 GOLDEN EAGLE PT
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-7403
Mailing Address - Country:US
Mailing Address - Phone:407-323-2704
Mailing Address - Fax:
Practice Address - Street 1:2736 GOLDEN EAGLE PT
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-7403
Practice Address - Country:US
Practice Address - Phone:407-323-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21108225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3186Medicare ID - Type Unspecified