Individual
GABRIELLE MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21758 STATE ROAD 54, LUTZ, FL 33549-6921
(813) 563-6070
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11025313
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118630100
—
FL
01
—
T1JE4
BCBS
FL
Enumeration date
06/05/2023
Last updated
02/09/2026
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