Provider Demographics
NPI:1518063379
Name:COLLIER, PATRICE M (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:M
Last Name:COLLIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 570046
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33257-0046
Mailing Address - Country:US
Mailing Address - Phone:305-878-3231
Mailing Address - Fax:
Practice Address - Street 1:1446 N KROME AVE # 102A
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-2432
Practice Address - Country:US
Practice Address - Phone:305-878-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT11484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0019ZMedicare ID - Type Unspecified