Provider Demographics
NPI:1952688160
Name:COLL, RUBEN DARIO (ARNP)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:DARIO
Last Name:COLL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7962 NW 113TH PL
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2537
Mailing Address - Country:US
Mailing Address - Phone:786-586-3160
Mailing Address - Fax:
Practice Address - Street 1:7962 NW 113TH PL
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33178-2537
Practice Address - Country:US
Practice Address - Phone:786-586-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9277696363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health