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General NPI Number Information
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NPI Number | 1154555845
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Entity Type | Organization
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Legal Business Name | COLLINS HEALTHCARE LLC
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 301 COLONY BLVD
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City | THE VILLAGES
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State | FL
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Zip | 32162-6085
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Country | US
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Telephone | 352-259-1621
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Fax |
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Provider Business Mailing Address
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Address Line | 6795 SW 131ST PL
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City | OCALA
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State | FL
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Zip | 34473-1914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. PAUL COLLINS
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Credential |
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Telephone | 859-312-2972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 4011
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License Number State | FL
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