Gulf Coast Mobile Medicine, LLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9102277 Issued in FL

Legal business name

GULF COAST MOBILE MEDICINE, LLC

Practice address

8655 Ibis Cove Cir
Naples, FL 34119-7728

Phone

(239) 455-8047

Fax

(239) 455-8048

NPI assigned

Aug 18, 2011

Last updated

Aug 18, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Marc E. McCollaum, PA-CNPI 1871545046

Title

Managing Member

Phone

(239) 455-8048

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marc Edwin McCollaum, PA-C

  • Physician Assistant
  • Naples, FL
  • NPI 1871545046
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1417237785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8655 IBIS COVE CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341197728",
            "telephone_number": "239-455-8047",
            "fax_number": "239-455-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 IBIS COVE CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341197728",
            "telephone_number": "239-455-8047",
            "fax_number": "239-455-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST MOBILE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "MCCOLLAUM",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "239-455-8048",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9102277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Bernadette Gulapa, PT
• Maryrose V Gulapa, PT, DPT
• Gulf Coast Assisting Hands, Inc. (Assisting Hands Naples)
• Gulf Coast Concierge, LLC (Lorna Fedelem, MD and Associates)
• Gulf Coast Home Care Services, Inc. (Associated Home Health)
• Gulf Coast Mobility,Inc.
• Gulf Coast Respiratory Services LLC
• Gulf Coast Spine & Orthopaedic Institute PLLC
• Gulf Coast Spine & Sport, LLC
• Gulf Coast Telemedicine LLC

• Medical Physician Assistant in Naples, FL
• Providers in Naples, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.