Healthcare Provider Details

I. General information

NPI: 1548148836
Provider Name (Legal Business Name): JOHN PAUL COLLINS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 W KENNEDY BLVD STE 100
TAMPA FL
33609-2048
US

IV. Provider business mailing address

484 RIVERSIDE AVE
JACKSONVILLE FL
32202-4912
US

V. Phone/Fax

Practice location:
  • Phone: 813-212-2483
  • Fax:
Mailing address:
  • Phone: 566-783-4848
  • Fax: 856-678-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT43644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: