Provider Demographics
NPI:1205713963
Name:COLLINS, DIAMOND (DO8284)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DO8284
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-2920
Mailing Address - Country:US
Mailing Address - Phone:904-641-7178
Mailing Address - Fax:
Practice Address - Street 1:11900 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-2920
Practice Address - Country:US
Practice Address - Phone:904-641-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO8284156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician