| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 09/24/2007 |
| Last Update Date | 08/05/2020 |
| Certification Date | 08/05/2020 |
| Medicare PECOS PAC ID | 7315070836 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164573663 PECOS PAC ID: 5597898015 Enrollment ID: I20100804001142 |
| Provider Name | Linda Ann Olds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699826198 PECOS PAC ID: 1052556446 Enrollment ID: I20130408000426 |
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