Provider Demographics
NPI:1588096804
Name:COLLINS, BRANSON J (MD)
Entity type:Individual
Prefix:
First Name:BRANSON
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 NW 13TH STREET, STE 400 FL 4
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2342
Mailing Address - Country:US
Mailing Address - Phone:561-297-4814
Mailing Address - Fax:561-297-4828
Practice Address - Street 1:880 NW 13TH STREET, STE 400 FL 4
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2342
Practice Address - Country:US
Practice Address - Phone:561-297-4814
Practice Address - Fax:561-297-4828
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09338300207L00000X
IDM-12516207L00000X, 207LP2900X
FLME151296207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine