Organization
COLLIER HMA PHYSICIAN MANANGEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
9240 BONITA BEACH RD SE, SUITE 2206, BONITA SPRINGS, FL 34135-4249
(239) 948-5505
(239) 948-5583
Mailing address
9240 BONITA BEACH RD SE, SUITE 2206, BONITA SPRINGS, FL 34135-4249
(239) 948-5505
(239) 948-5583
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Enumeration date
10/07/2006
Last updated
03/09/2022
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