Collis, George N

Collis, George N is an individual health care provider with primary practice located at 1223 Gateway Dr Suite 2B, Melbourne FL 32901-2607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Collis, George N can be contacted via phone (321) 725-4500.

Contact Information

Primary practice address
1223 Gateway Dr Suite 2B Melbourne FL 32901-2607
Phone: (321) 725-4500
Fax: (321) 676-9731
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X ME102568 Florida

Profile Details

NPI number 1134367964
LBN Legal business name Collis, George N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2009
Last updated May 1st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134367964 NPPES
Florida MEDICAID 015353800
Florida Other IF391Z
Florida Other IF391Y

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