George N Collis
Plastic and Reconstructive Surgery
1223 Gateway Dr Suite 2b
Melbourne
, Florida 32901-2607
George N Collis
Plastic and Reconstructive Surgery
1223 Gateway Dr Suite 2b
Melbourne
, Florida 32901-2607
(321) 951-7408
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- George N Collis
- 3300 S Fiske Blvd
- Rockledge, FL
- Zip : 32955-4306
- Fax : (321) 951-7408
- Phone : (321) 725-4500
Second Address
- George N Collis
- 1223 Gateway Dr Suite 2b
- Melbourne, FL
- Zip : 32901-2607
- Fax : (321) 676-9731
- Phone : (321) 725-4500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | ME102568 | FL |
National Provider Identifier
| NPI | 1134367964 |
|---|---|
| Provider Name | George N Collis |
| First Address | Rockledge, FL 32955-4306 |
| Second Address | Melbourne, FL 32901-2607 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/02/2009 |
| Last Update Date | 01/05/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 015353800 | (05) | FL |
| IF391Y | MEDICARE (01) | FL |
| IF391Z | MEDICARE (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.