Organization
COLLIER OTOLARYNGOLOGY-HEAD AND NECK SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE A. MELLO (PRACTICE MANAGER)
(239) 592-9666
Entity
Organization
Contact information
Practice address
1879 VETERANS PARK DR, SUITE 1201, NAPLES, FL 34109-0492
(239) 262-6668
(239) 262-0017
Mailing address
1879 VETERANS PARK DR, SUITE 1201, NAPLES, FL 34109-0492
(239) 592-9666
(239) 592-1835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0063724
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K1003
MEDICARE PTAN
FL
Enumeration date
10/17/2007
Last updated
03/11/2011
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