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General NPI Number Information
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NPI Number | 1992099535
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Entity Type | Individual
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Provider Name | JACQUELINE MIRENDA COLLINS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE STE 1200
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-3941
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Fax |
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Provider Business Mailing Address
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Address Line | 11100 EUCLID AVE STE 1200
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-3941
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A151357
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35.138284
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License Number State | OH
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