MEDICARE: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416A0800X	Air Ambulance	3140	FL
2	3416L0300X	Land Ambulance	3140	FL
3	341600000X	Ambulance	3140	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	590000001	OTHER	FL	RAILROAD PROVIDER ID

General Provider Information

NPI Number	:	1083674519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS

Provider Business Mailing Address
First Line	:	PO BOX 7789
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34101-7789
Country	:	US
Telephone Number	:	239-252-3754
Fax Number	:

Provider Business Practice Location Address
First Line	:	8075 LELY CULTURAL PARKWAY
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-7789
Country	:	US
Telephone Number	:	239-252-3740
Fax Number	:	239-252-3898

Authorized Official
Title or Position	:	CHIEF
Name	:	TABATHA BUTCHER
Credential	:
Telephone Number	:	239-252-3780

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	06/16/2018

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Directions to “COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS ” Practice Location

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