MEDICARE: BARBARA S COLEMAN LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA41908	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	611010600	OTHER	FL	WORKMAN'S COMPENSATION

General Provider Information

NPI Number	:	1770735573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA S COLEMAN LMT

Provider Business Mailing Address
First Line	:	35850 OSPREY LN
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32736-9123
Country	:	US
Telephone Number	:	352-988-8182
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 N DONNELLY ST
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-2814
Country	:	US
Telephone Number	:	352-988-8182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2008
Last Update Date	:	10/13/2008

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Directions to “ BARBARA S COLEMAN LMT” Practice Location

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