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General NPI Number Information
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NPI Number | 1003072331
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Entity Type | Organization
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Legal Business Name | CYNTHIA L COLLAWN MD P A
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 1219 S EAST AVE SUITE 101
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City | SARASOTA
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State | FL
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Zip | 34239-2340
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Country | US
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Telephone | 941-954-4373
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 S EAST AVE SUITE 101
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City | SARASOTA
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State | FL
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Zip | 34239-2340
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Country | US
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Telephone | 941-954-4373
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CYNTHIA L COLLAWN
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Credential | MD
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Telephone | 941-954-4373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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