Healthcare Provider Details

I. General information

NPI: 1871543512
Provider Name (Legal Business Name): COLLIER NEUROLOGIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BAILEY LN STE 200
NAPLES FL
34105-8523
US

IV. Provider business mailing address

3200 BAILEY LN STE 200
NAPLES FL
34105-8523
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-8971
  • Fax: 239-262-5903
Mailing address:
  • Phone: 239-262-1721
  • Fax: 239-262-1045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: ELAINE GARNER
Title or Position: ADMINISTRATOR
Credential:
Phone: 239-262-8971