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General NPI Number Information
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NPI Number | 1073707741
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Entity Type | Organization
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Legal Business Name | COLLIER HEALTH SERVICES INC
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 1749 HERITAGE TRL # 801
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City | NAPLES
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State | FL
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Zip | 34112-7591
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Country | US
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Telephone | 239-658-3000
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Fax | 239-774-2317
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Provider Business Mailing Address
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Address Line | 1454 MADISON AVE W
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City | IMMOKALEE
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State | FL
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Zip | 34142-2200
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Country | US
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Telephone | 239-658-3000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TAMI RAZNOFF
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Credential |
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Telephone | 239-986-0136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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