Coastal Rehab
NPI 1700640901 · Physical Therapist · New Smyrna Beach, FL
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1700640901
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Phyleischa Owen, Manager(407) 312-4613
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Chiropractor111N00000X
Chiropractic Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 103 Club House CirNew Smyrna Beach, FL 32168-7967Phone: (386) 235-4412Fax: (407) 605-0699
Registry dates
- Enumerated
- 2024-02-08
- Last updated
- 2024-06-18
- Certified
- 2024-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.