Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME145729 | FL |
Y | 111NI0900X | Internist | ME145729 | FL |
NPI | 1003178765 |
---|---|
Provider Name | Dr. Stanton Keith Collins |
First Address | Hollywood, FL 33026-4852 |
Second Address | Miami Beach, FL 33140-2818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2012 |
Last Update Date | 27/05/2021 |