Healthcare Provider Details

I. General information

NPI: 1588096804
Provider Name (Legal Business Name): BRANSON J COLLINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 NW 13TH STREET, STE 400 FL 4
BOCA RATON FL
33486-2342
US

IV. Provider business mailing address

880 NW 13TH STREET, STE 400 FL 4
BOCA RATON FL
33486-2342
US

V. Phone/Fax

Practice location:
  • Phone: 561-297-4814
  • Fax: 561-297-4828
Mailing address:
  • Phone: 561-297-4814
  • Fax: 561-297-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA09338300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberM-12516
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberM-12516
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME151296
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: