MEDICARE: COLLIN DEES PA-C

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	363A00000X	Physician Assistant	PA9115205	FL
2	363A00000X	Physician Assistant	085.010788	IL
3	363A00000X	Physician Assistant	3602	NH
4	363A00000X	Physician Assistant	032887	NY
5	363A00000X	Physician Assistant	PA2827	ME
6	363A00000X	Physician Assistant	MED-PAC-LIC-113639	MT

General Provider Information

NPI Number	:	1508418260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLIN DEES PA-C

Provider Business Mailing Address
First Line	:	502 S DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3906
Country	:	US
Telephone Number	:	813-203-2052
Fax Number	:	813-304-2121

Provider Business Practice Location Address
First Line	:	502 S DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3906
Country	:	US
Telephone Number	:	813-203-2052
Fax Number	:

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

Provider Enumeration Date	:	07/12/2019
Last Update Date	:	05/12/2026

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Directions to “ COLLIN DEES PA-C” Practice Location

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