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Organization

COLLIER BOULEVARD HMA PHYSICIAN MANAGEMENT LLC

Active
Other names
Collier Boulevard HMA Physician Management LLC, Physicians Regional Medical Group-Collier
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
8340 COLLIER BLVD STE 202, NAPLES, FL 34114-3589
(239) 348-4583
(239) 348-4553
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001609607
FL
Enumeration date
06/15/2021
Last updated
03/14/2022
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