Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251P0200X | Physical Therapist - Pediatrics | 012846-1 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | PT30120 | FL |
NPI | 1083760037 |
---|---|
Provider Name | Dr. Brenda M Collins |
First Address | Summerfield, FL 34491-7037 |
Second Address | Summerfield, FL 34491-7037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 03/11/2020 |