| |
1454 Madison Ave W Immokalee FL 34142-2200 | |
(239) 658-3064 | |
(239) 658-3175 |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1454 Madison Ave W, Immokalee, Florida |
Authorized Official Name and Position | Sharon Aragona (VICE PRESIDENT) |
Authorized Official Contact | 2396583035 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1454 Madison Ave W Immokalee FL 34142-2200 Ph: (239) 658-3064 | 1454 Madison Ave W Immokalee FL 34142-2200 Ph: (239) 658-3064 |
NPI Number | 1073792297 |
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Provider Enumeration Date | 10/25/2007 |
Last Update Date | 02/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073792297 | NPI | - | NPPES |
101901 | Other | FL | MEDICARE FQHC PROVIDER NO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Collier Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W, Immokalee, FL 34142 Phone: 239-658-3000 Fax: 239-932-6935 | |
Collier Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1454 Madison Ave W Unit 3, Immokalee, FL 34142 Phone: 239-658-3000 | |