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General NPI Number Information
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NPI Number | 1578909347
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Entity Type | Individual
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Provider Name | KRISTAMARIE F COLLMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 341 N MAITLAND AVE STE 285
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City | MAITLAND
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State | FL
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Zip | 32751-4761
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Country | US
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Telephone | 407-205-2994
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Fax | 407-550-3794
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Provider Business Mailing Address
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Address Line | 341 N MAITLAND AVE STE 285
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City | MAITLAND
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State | FL
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Zip | 32751-4761
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Country | US
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Telephone | 407-205-2994
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Fax | 407-550-3794
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME121353
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 076490
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101265105
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License Number State | VA
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