Individual
COLLIN JAMES TACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(954) 848-8152
Mailing address
9505 49TH ST N APT 2-308, PINELLAS PARK, FL 33782-5290
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
FL
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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