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General NPI Number Information
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NPI Number | 1063303428
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Entity Type | Organization
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Legal Business Name | WANDA JEAN COLLINS PLAN ADMINISTRATOR
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 5440 N STATE ROAD 7 STE 212
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City | FORT LAUDERDALE
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State | FL
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Zip | 33319-2900
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Country | US
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Telephone | 561-399-9371
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Fax |
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Provider Business Mailing Address
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Address Line | 3686 NW 95TH TER # 4M
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City | SUNRISE
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State | FL
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Zip | 33351-6463
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Country | US
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Telephone | 561-399-9371
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Fax |
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Authorized Official
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Title or Position | PLAN ADMINISTRATOR
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Name | WANDA COLLINS
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Credential |
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Telephone | 561-399-9371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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