Organization
COLLINS PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization
Contact information
Practice address
4300 ALTON RD, MIAMI BEACH, FL 33140-2948
(305) 481-9776
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
(337) 262-7246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100712700
—
FL
Enumeration date
08/01/2018
Last updated
09/17/2024
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