Provider Demographics
NPI:1205123742
Name:COLLIER, THERESA MARIA (DO)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIA
Last Name:COLLIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14720 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7450
Mailing Address - Country:US
Mailing Address - Phone:305-951-2152
Mailing Address - Fax:
Practice Address - Street 1:2929 N UNIVERSITY DR STE 108
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5047
Practice Address - Country:US
Practice Address - Phone:954-340-1992
Practice Address - Fax:954-340-1430
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA276276207RE0101X
ORDO179409207RE0101X
VT032-0134154207RE0101X
FLOS11351208M00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006303500Medicaid
FL006303500Medicaid