Organization
COLLIER HEALTH SERVICES INC
Active
Other names
Ronald McDonald Care Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI RAZNOFF (CFO)
(239) 986-0136
Entity
Organization
Contact information
Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3000
(239) 658-3050
Mailing address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3000
(239) 658-3050
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
683955007
—
FL
Enumeration date
05/14/2007
Last updated
01/19/2023
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