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NPI Code Detail

MEDICARE: ELEANA COLL LCSW 87111

MEDICARE:   ELEANA  COLL  LCSW 87111
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
11041C0700XClinical Social WorkerSW21829FL
21041C0700XClinical Social Worker87111CA

General Provider Information

NPI Number : 1710399670
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELEANA COLL LCSW 87111
Provider Business Mailing Address
First Line : 3803 ANDALUSIA BLVD
Second Line :
City : CAPE CORAL
State : FL
Zip : 33909-6242
Country : US
Telephone Number : 754-229-5867
Fax Number :
Provider Business Practice Location Address
First Line : 2180 CENTRAL FLORIDA PKWY STE A1
Second Line :
City : ORLANDO
State : FL
Zip : 32837-8900
Country : US
Telephone Number : 754-229-5867
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2014
Last Update Date : 03/04/2026

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Directions to “ ELEANA COLL LCSW 87111” Practice Location

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