# COLLIER HEALTH SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ronald McDonald Care Mobile
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770798688
- **Authorized official:** TAMI RAZNOFF (CFO)
- **Authorized official phone:** (239) 986-0136

## Contact information

- **Practice address:** 1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
- **Practice address phone:** (239) 658-3000
- **Practice address fax:** (239) 658-3050
- **Mailing address:** 1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
- **Mailing address phone:** (239) 658-3000
- **Mailing address fax:** (239) 658-3050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2007
- **Last updated:** 01/19/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 683955007 | — | FL |