Robert W Olds Md Pa | |
301 Health Park Blvd Ste 326 Saint Augustine FL 32086-5771 | |
(904) 834-9647 | |
Not Available |
Full Name | Robert W Olds Md Pa |
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Speciality | Psychiatry & Neurology |
Location | 301 Health Park Blvd Ste 326, Saint Augustine, Florida |
Authorized Official Name and Position | Robert Olds (OWNER) |
Authorized Official Contact | 9048349647 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Robert W Olds Md Pa Po Box 3123 St Augustine FL 32085-3123 Ph: () - | Robert W Olds Md Pa 301 Health Park Blvd Ste 326 Saint Augustine FL 32086-5771 Ph: (904) 834-9647 |
NPI Number | 1215123195 |
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Provider Enumeration Date | 09/24/2007 |
Last Update Date | 05/16/2024 |
Certification Date | 05/16/2024 |
Medicare PECOS PAC ID | 7315070836 |
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Medicare Enrollment ID | O20100804001124 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215123195 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | ME35901 (Florida) | Primary |
Provider Name | Robert W Olds |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1164573663 PECOS PAC ID: 5597898015 Enrollment ID: I20100804001142 |
Provider Name | Linda Ann Olds |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1699826198 PECOS PAC ID: 1052556446 Enrollment ID: I20130408000426 |
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