MEDICARE: DR. COLLEEN S MAXCY MD

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	208100000X	Physical Medicine & Rehabilitation Physician	ME107168	FL

General Provider Information

NPI Number	:	1750529483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLLEEN S MAXCY MD

Provider Business Mailing Address
First Line	:	300 STATE ST E STE 222
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3711
Country	:	US
Telephone Number	:	813-855-8400
Fax Number	:	813-855-9200

Provider Business Practice Location Address
First Line	:	300 STATE ST E STE 222
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3711
Country	:	US
Telephone Number	:	813-855-8400
Fax Number	:	813-855-9200

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

Provider Enumeration Date	:	02/03/2009
Last Update Date	:	03/25/2024

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Directions to “ DR. COLLEEN S MAXCY MD” Practice Location

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