MEDICARE: SCOTT COLLIER CST/CSFA

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	363AS0400X	Surgical Physician Assistant	213255

General Provider Information

NPI Number	:	1568240703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT COLLIER CST/CSFA

Provider Business Mailing Address
First Line	:	11629 GWYNFORD LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-7253
Country	:	US
Telephone Number	:	904-613-7158
Fax Number	:

Provider Business Practice Location Address
First Line	:	11629 GWYNFORD LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-7253
Country	:	US
Telephone Number	:	904-613-7158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	05/27/2026

Similar Medicare Providers

1417888710 — COLLIER SURGICAL SERVICES LLC
Practice Location Address:

11629 GWYNFORD LN
JACKSONVILLE, FL
32223-7253

Practice Phone: 904-613-7158
Practice Fax:

1871059840 — E & I PICC PARTNERS INC
Practice Location Address:

6431 POTTSBURG DR
JACKSONVILLE, FL
32211-7253

Practice Phone: 904-318-8491
Practice Fax:

1851066492 — LAWANA RILEY
Practice Location Address:

7253 KOLEDA DR
JACKSONVILLE, FL
32210-2648

Practice Phone: 904-258-4328
Practice Fax:

1710818042 — ASHLY ANDREWS CCC SLP
Practice Location Address:

12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-886-3228
Practice Fax: 904-485-8876

1386988939 — HAULEK TAWMGING ,DNP, ARNP, PMHNP-BC
Practice Location Address:

12443 SAN JOSE BLVD STE 601D
JACKSONVILLE, FL
32223-8652

Practice Phone: 206-486-0424
Practice Fax:

1821929530 — RALEI V WINE OTD
Practice Location Address:

12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL
32223-8618

Practice Phone: 904-886-3228
Practice Fax:

Directions to “ SCOTT COLLIER CST/CSFA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.