Provider Demographics
NPI:1265826721
Name:COLLABORATIVE HANDS
Entity Type:Organization
Organization Name:COLLABORATIVE HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AND BILLING SPECIALIS
Authorized Official - Prefix:MS
Authorized Official - First Name:JO ANN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-501-7462
Mailing Address - Street 1:4430 CRABAPPLE DR
Mailing Address - Street 2:204
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4286
Mailing Address - Country:US
Mailing Address - Phone:813-501-7462
Mailing Address - Fax:
Practice Address - Street 1:8875 HIDDEN RIVER PKWY
Practice Address - Street 2:STE 300
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-1035
Practice Address - Country:US
Practice Address - Phone:813-501-7462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW111971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHS255AMedicare PIN