Provider Demographics
| NPI: | 1124819172 |
|---|---|
| Name: | COLLIER HMA PHYSICIAN MANAGEMENT LLC |
| Entity type: | Organization |
| Organization Name: | COLLIER HMA PHYSICIAN MANAGEMENT LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR, PROVIDER ENROLLMENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KRISTINA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MUSIC |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 877-892-9815 |
| Mailing Address - Street 1: | PO BOX 689022 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FRANKLIN |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37068-9022 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 615-465-7211 |
| Mailing Address - Fax: | 615-628-6877 |
| Practice Address - Street 1: | 6376 PINE RIDGE RD UNIT 420 |
| Practice Address - Street 2: | |
| Practice Address - City: | NAPLES |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 34119-3908 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 239-348-4279 |
| Practice Address - Fax: | 239-348-4438 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-05-16 |
| Last Update Date: | 2025-05-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |