Organization
COLLIER ANESTHESIA PA
Active
Organization
COLLIER ANESTHESIA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA M WATERHOUSE (EXECUTIVE DIRECTOR)
(239) 261-1158
Entity
Organization
Contact information
Practice address
1336 CREEKSIDE BLVD., SUITE 1, NAPLES, FL 34108
(239) 261-1158
(239) 261-4232
Mailing address
PO BOX 674391, DETROIT, MI 48267-4391
(239) 261-1158
(239) 261-4232
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371075100
—
FL
01
—
39347
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
11/07/2005
Last updated
07/21/2022
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