Healthcare Provider Details

I. General information

NPI: 1851219406
Provider Name (Legal Business Name): MEDSOLCOLLINS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 NE 2ND AVE # 21B
MIAMI SHORES FL
33138-2722
US

IV. Provider business mailing address

9600 NE 2ND AVE # 21B
MIAMI SHORES FL
33138-2722
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-8765
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GREG LUBIN
Title or Position: OWNER
Credential: ETC
Phone: 315-654-8997