Provider Demographics
NPI:1205870110
Name:COLLINS, DENNIS PATRICK (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:PATRICK
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:PATRICK
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6400 W NEWBERRY RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6605
Mailing Address - Country:US
Mailing Address - Phone:352-331-8902
Mailing Address - Fax:352-224-1094
Practice Address - Street 1:6400 W NEWBERRY RD
Practice Address - Street 2:SUITE 302
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6605
Practice Address - Country:US
Practice Address - Phone:352-331-8902
Practice Address - Fax:352-224-1094
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79264207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019826100Medicaid
FL272817600Medicaid
I36472Medicare UPIN
FL16305Medicare ID - Type Unspecified