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 DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
6376 PINE RIDGE RD UNIT 300, NAPLES, FL 34119-3905
(239) 348-4221
(239) 348-4149
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
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
07/23/2021
Last updated
05/19/2022
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