MEDICARE: DR. CLIFFORD D. COLIN MD

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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	ME0017690	FL

General Provider Information

NPI Number	:	1952367047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFFORD D. COLIN MD

Provider Business Mailing Address
First Line	:	5056 WATERSIDE DR
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-6215
Country	:	US
Telephone Number	:	727-845-5707
Fax Number	:	727-569-0295

Provider Business Practice Location Address
First Line	:	6117 TROUBLE CREEK RD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-5240
Country	:	US
Telephone Number	:	727-845-5707
Fax Number	:	727-569-0295

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	10/28/2009

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