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General NPI Number Information
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NPI Number | 1528293750
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Entity Type | Individual
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Provider Name | JASON ANDREW COLLINS MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 241 NOKOMIS AVE S STE B
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City | VENICE
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State | FL
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Zip | 34285-2319
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Country | US
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Telephone | 941-485-3302
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Fax | 941-485-2673
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Provider Business Mailing Address
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Address Line | PO BOX 112727
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City | GAINESVILLE
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State | FL
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Zip | 32611-2727
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Country | US
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Telephone | 352-273-7002
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Fax | 352-273-7388
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME120473
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME120473
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License Number State | FL
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