# COLLIER BOULEVARD HMA PHYSICIAN MANAGEMENT LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Collier Boulevard HMA Physician Management LLC, Physicians Regional Medical Group-Collier
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477124469
- **Authorized official:** JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 8340 COLLIER BLVD STE 303, NAPLES, FL 34114-3626
- **Practice address phone:** (239) 348-4400
- **Practice address fax:** (239) 348-4197
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-7211
- **Mailing address fax:** (615) 628-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | — | NULL | Yes |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 07/09/2021
- **Last updated:** 03/09/2022