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 ONBOARDING & PROV ENROLLMENT)
(615) 465-3334
Entity
Organization
Contact information
Practice address
8340 COLLIER BLVD STE 200, NAPLES, FL 34114-3589
(239) 348-4553
(239) 348-4583
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(877) 892-9815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
10/13/2021
Last updated
03/09/2022
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