MEDICARE: DR. PAUL E COLLINS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC4011	FL

General Provider Information

NPI Number	:	1265545768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL E COLLINS OD

Provider Business Mailing Address
First Line	:	2909 TRAVERSE TRL
Second Line	:	EYESITE OF THE VILLAGES
City	:	THE VILLAGES
State	:	FL
Zip	:	32163-2017
Country	:	US
Telephone Number	:	352-674-3937
Fax Number	:	352-633-8713

Provider Business Practice Location Address
First Line	:	2909 TRAVERSE TRL
Second Line	:	EYESITE OF THE VILLAGES
City	:	THE VILLAGES
State	:	FL
Zip	:	32163-2017
Country	:	US
Telephone Number	:	352-674-3937
Fax Number	:	352-633-8713

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	08/21/2015

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