Healthcare Provider Details

I. General information

NPI: 1205870110
Provider Name (Legal Business Name): DENNIS PATRICK COLLINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DENNIS PATRICK COLLINS

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 W NEWBERRY RD SUITE 302
GAINESVILLE FL
32605-6605
US

IV. Provider business mailing address

6400 W NEWBERRY RD SUITE 302
GAINESVILLE FL
32605-6605
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-8902
  • Fax: 352-224-1094
Mailing address:
  • Phone: 352-331-8902
  • Fax: 352-224-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME79264
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: