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General NPI Number Information
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NPI Number | 1790115681
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Entity Type | Individual
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Provider Name | CALVIN COLLINS JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 4403 VINELAND RD SUITE B5
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City | ORLANDO
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State | FL
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Zip | 32811
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Country | US
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Telephone | 407-682-8392
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 150249
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32715-0249
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Country | US
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Telephone | 407-682-8392
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Fax |
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | ME13944
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License Number State | FL
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