Healthcare Provider Details

I. General information

NPI: 1780899690
Provider Name (Legal Business Name): COLLIER HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 S HEATHWOOD DR
MARCO ISLAND FL
34145-5026
US

IV. Provider business mailing address

40 S HEATHWOOD DR
MARCO ISLAND FL
34145-5026
US

V. Phone/Fax

Practice location:
  • Phone: 239-394-0693
  • Fax: 239-642-2321
Mailing address:
  • Phone: 239-394-0693
  • Fax: 239-642-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARON B ARAGONA
Title or Position: VICE PRESIDENT
Credential:
Phone: 239-658-3035