Healthcare Provider Details

I. General information

NPI: 1346349545
Provider Name (Legal Business Name): RACHEL M COLEMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 352-733-1770
  • Fax: 352-372-5164
Mailing address:
  • Phone: 352-733-1770
  • Fax: 352-372-5164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number230225
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME110864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: