Collier Boulevard Hma Physician Management Llc
Legal Business Name
Collier Boulevard Hma Physician Management Llc
NPI Number
1508098344
NPI Type
Organization
Enumeration Date
08/12/2009
Specialties
(Taxonomies)Name
Code
207N00000X
207VG0400X
207R00000X
207V00000X
207W00000X
207X00000X
133V00000X
208600000X
2086S0105X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
8340 COLLIER BLVD
8340 COLLIER BLVD
City
Naples
Naples
State
FL
FL
Postal Code
34114-3625
34114-3625
Country
US
US
Telephone Number
N/A
(239) 354-4301
Authorized Official
Name
Ms. Jennifer Jackson
Title or Position
SENIOR DIRECTOR PROVIDER ENROLLMENT
Telephone Number
(615) 465-3334
Identifiers
Identifier
001609600
Identifier State
FL
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/09/2022