Individual
COLLEEN RENEE MACINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27950 US HIGHWAY 27, LEESBURG, FL 34748-9050
(813) 321-1786
(813) 321-1787
Mailing address
18228 N US HIGHWAY 41, LUTZ, FL 33549-4400
(813) 321-1786
(813) 321-1787
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME100399
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME100399
FL
Other
Enumeration date
06/11/2006
Last updated
03/24/2026
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