| |
1454 Madison Ave W Immokalee FL 34142-2200 | |
(239) 658-3000 | |
(239) 658-3063 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1454 Madison Ave W, Immokalee, Florida |
Authorized Official Name and Position | Sandra E Steele-riordan (CFO) |
Authorized Official Contact | 2396583003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1454 Madison Ave W Immokalee FL 34142-2200 Ph: (239) 658-3000 | 1454 Madison Ave W Immokalee FL 34142-2200 Ph: (239) 658-3000 |
NPI Number | 1184707689 |
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Provider Enumeration Date | 10/20/2006 |
Last Update Date | 03/07/2023 |
Medicare PECOS PAC ID | 4183521925 |
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Medicare Enrollment ID | O20100930068558 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184707689 | NPI | - | NPPES |
5133530001 | Other | FL | DME MEDICARE |
102892801 | Medicaid | FL | |
1031563 | Other | FL | NABP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | PH6822 (Florida) | 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 | |