MEDICARE: COLLEEN ELIZABETH VIRGINS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	688268	FL

General Provider Information

NPI Number	:	1689514770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN ELIZABETH VIRGINS

Provider Business Mailing Address
First Line	:	2710 NW 55TH AVE
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-1530
Country	:	US
Telephone Number	:	954-644-0248
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 NW 55TH AVE
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-1530
Country	:	US
Telephone Number	:	954-644-0248
Fax Number	:

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

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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Directions to “ COLLEEN ELIZABETH VIRGINS ” Practice Location

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