Individual
GEORGE N COLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 549-0541
(321) 676-9731
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 549-0541
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME102568
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015353800
—
FL
01
—
IF391Y
MEDICARE
FL
01
—
IF391Z
MEDICARE
FL
Enumeration date
02/02/2009
Last updated
04/10/2026
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