MEDICARE: DONALD M. COLLINS, M.D., P.A.

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	207R00000X	Internal Medicine Physician	ME82417	FL

General Provider Information

NPI Number	:	1396811675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD M. COLLINS, M.D., P.A.

Provider Business Mailing Address
First Line	:	1109 LUCERNE TER
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-1016
Country	:	US
Telephone Number	:	407-843-4251
Fax Number	:	407-843-6461

Provider Business Practice Location Address
First Line	:	1109 LUCERNE TER
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-1016
Country	:	US
Telephone Number	:	407-843-4251
Fax Number	:	407-843-6461

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD MICHAEL COLLINS
Credential	:	M.D.
Telephone Number	:	407-843-4251

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	03/04/2008

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