Collier Medical, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME113936 Issued in FL

Legal business name

COLLIER MEDICAL, LLC

Practice address

12565 Collier Blvd
Naples, FL 34116-5243

Phone

(239) 455-9919

Fax

(239) 455-9906

NPI assigned

Mar 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Elvira Tolentino, M.D.NPI 1497026496

Title

Owner

Phone

(862) 377-4088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elvira P Tolentino, MD

  • General Practice Physician
  • Naples, FL
  • NPI 1497026496
  Medicare reassignment Care Compare group NPD Authorized official
• Susan Wakesho Ngondo

  • Family Nurse Practitioner
  • Marco Island, FL
  • NPI 1962088047
  Medicare reassignment Care Compare group NPD
• Viola Maf Jacob, MD

  • General Practice Physician
  • Oviedo, FL
  • NPI 1972597193
  NPD (past)

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1891036372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 WILLO PINES LN",
            "city": "MONTVERDE",
            "state": "FL",
            "postal_code": "347563500",
            "telephone_number": "862-377-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12565 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165243",
            "telephone_number": "239-455-9919",
            "fax_number": "239-455-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "TOLENTINO",
        "authorized_official_first_name": "ELVIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-377-4088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME113936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collier Hma Physician Management, Inc.
• Collier Hma Physician Management, LLC
• Collier Hma Physician Management, LLC
• Collier Home Care LLC
• Collier Medical Specialists, Inc
• Collier Neurologic Specialists LLC
• Collier Otolaryngology Hearing Center
• Collier Otolaryngology-Head and Neck Surgery PA
• Collier Pathology Services P a
• Collier Pharmaceutical Services Inc

• Primary Care Clinic/Center in Naples, FL
• Providers in Naples, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.