# COLLABORATIVE MEDICAL HOME SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194278192
- **Authorized official:** DIANA O'CONNOR ARNP. PH.D. (PRESIDENT)
- **Authorized official phone:** (561) 632-2898

## Contact information

- **Practice address:** 3744 CYPRESS LAKE DR, LAKE WORTH, FL 33467-2203
- **Practice address phone:** (561) 907-7413
- **Mailing address:** 3744 CYPRESS LAKE DR, LAKE WORTH, FL 33467-2203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | — | FL | Yes |

## Other

- **Enumeration date:** 07/27/2016
- **Last updated:** 04/25/2017