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General NPI Number Information
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NPI Number | 1295097368
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Entity Type | Organization
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Legal Business Name | ROBERT COLEMAN PSYD LLC
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 11200 SEMINOLE BLVD STE 101
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City | LARGO
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State | FL
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Zip | 33778-3240
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Country | US
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Telephone | 727-272-0097
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Fax |
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Provider Business Mailing Address
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Address Line | 11200 SEMINOLE BLVD STE 101
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City | LARGO
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State | FL
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Zip | 33778-3240
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Country | US
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Telephone | 727-272-0097
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT M COLEMAN
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Credential | PSYD
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Telephone | 727-272-0097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY8157
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License Number State | FL
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