Organization
COLLIER HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Collier HMA Physician Management LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
6376 PINE RIDGE RD, NAPLES, FL 34119-3905
(239) 348-4221
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
09/10/2021
Last updated
03/09/2022
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