Most Relevant Information
Provider Data
| NPI Number: | 1003554676 |
| Provider Name: | SHANNON COLLINS MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 35300 |
Most Important Dates
| Enumeration Date: | 05/24/2022 |
| Last Updated: | 05/26/2022 |
Provider Practice Location
3501 JOHNSON ST
HOLLYWOOD
FL
330215421
Practice Location Phone/Fax
| Phone: | 9548444491 |
| Fax: |
Provider Mailing Location
3501 JOHNSON ST
HOLLYWOOD
FL
330215421
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |