Organization
COLLIER HEART GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R. AXLINE M.D. (PARTNER)
(239) 659-0102
Entity
Organization
Contact information
Practice address
311 9TH ST N, SUITE 304, NAPLES, FL 34102-5885
(239) 659-0102
(239) 659-0108
Mailing address
PO BOX 850001, ORLANDO, FL 32885-0001
(239) 659-0102
(239) 659-0108
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00793
BCBS
FL
01
—
DE1357
RR MEDICARE
FL
Enumeration date
04/19/2006
Last updated
04/20/2008
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