Provider Demographics
NPI:1033939640
Name:COLLINS, MILANGEL SOFIA (PA)
Entity type:Individual
Prefix:
First Name:MILANGEL
Middle Name:SOFIA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11300 SW 13TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4352
Mailing Address - Country:US
Mailing Address - Phone:954-391-3729
Mailing Address - Fax:
Practice Address - Street 1:11300 SW 13TH ST APT 202
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4352
Practice Address - Country:US
Practice Address - Phone:954-391-3729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR770363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant