Collier Boulevard Hma Physician Management LLC
Internal Medicine in Marco Island, FL. Organization (NPI-2).
NPI number1952979080
StatusActive
Last updated in NPPESMar 14, 2022
Details
- NPI
- 1952979080
- Entity type
- Organization (NPI-2)
- Legal business name
- Collier Boulevard Hma Physician Management LLC
- Organization subpart
- No
- Enumeration date
- Jun 15, 2021
- Certification date
- Mar 14, 2022
- Last updated
- Mar 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207RG0300X | Internal Medicine, Geriatric Medicine | – | – | |
| 208800000X | Urology | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 363LA2200X | Nurse Practitioner, Adult Health | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Other names
- Physicians Regional Medical Group-Collier (Doing Business As)
- Collier Boulevard Hma Physician Management LLC (Doing Business As)
Practice location
1839 San Marco RdMarco Island, FL 34145-6722
Phone 239-394-1670 · Fax 239-394-1677
Mailing address
Po Box 689022Franklin, TN 37068-9022
Phone 615-465-7211 · Fax 615-628-6877
Authorized official
Jennifer L Jackson
Sr Dir Prov Enrollment & Onboarding
6154653334
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