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NPI Code Detail

MEDICARE: MRS. LAURA COLLINS PT CHT

MEDICARE: MRS. LAURA COLLINS PT CHT
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
1225100000XPhysical TherapistPT20430FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00208111OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y900TOTHERFLBLUE SHIELD
2Y900VOTHERFLBLUE SHIELD
4Y900UOTHERFLBLUE SHIED

General Provider Information

NPI Number : 1881677573
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA COLLINS PT CHT
Provider Business Mailing Address
First Line : PO BOX 820
Second Line :
City : PALMETTO
State : FL
Zip : 34220-0820
Country : US
Telephone Number : 941-729-1738
Fax Number : 941-722-7844
Provider Business Practice Location Address
First Line : 506 4TH AVE W
Second Line : BLDG 4
City : PALMETTO
State : FL
Zip : 34221-5203
Country : US
Telephone Number : 941-729-1800
Fax Number : 941-722-7844
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. LAURA COLLINS PT CHT” Practice Location

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