Healthcare Provider Details

I. General information

NPI: 1497692743
Provider Name (Legal Business Name): MADDISON ELIZABETH COLLINS M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12276 91ST TER
SEMINOLE FL
33772-3212
US

IV. Provider business mailing address

12276 91ST TER
SEMINOLE FL
33772-3212
US

V. Phone/Fax

Practice location:
  • Phone: 727-504-8265
  • Fax:
Mailing address:
  • Phone: 727-504-8265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA20351
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: