Provider Demographics
NPI:1144778788
Name:VINCENT, COLLEEN RENEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:RENEE
Last Name:VINCENT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3224
Mailing Address - Country:US
Mailing Address - Phone:407-303-2528
Mailing Address - Fax:407-303-2760
Practice Address - Street 1:1350 HICKORY ST
Practice Address - Street 2:SUITE 3G-16
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3224
Practice Address - Country:US
Practice Address - Phone:321-434-7243
Practice Address - Fax:321-434-5335
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2966222363LN0000X, 363LN0005X
FLAPRN2966222363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care