Organization
GULF COAST MOBILE MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC E. MCCOLLAUM PA-C (MANAGING MEMBER)
(239) 455-8048
Entity
Organization
Contact information
Practice address
8655 IBIS COVE CIR, NAPLES, FL 34119-7728
(239) 455-8047
(239) 455-8048
Mailing address
8655 IBIS COVE CIR, NAPLES, FL 34119-7728
(239) 455-8047
(239) 455-8048
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9102277
FL
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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