Provider Demographics
NPI:1033605050
Name:WALKER, COLLIN EDWARD
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:EDWARD
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7533 COUNTRY RUN PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8279
Mailing Address - Country:US
Mailing Address - Phone:407-701-7271
Mailing Address - Fax:
Practice Address - Street 1:7533 COUNTRY RUN PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-8279
Practice Address - Country:US
Practice Address - Phone:407-701-7271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle