Provider Demographics
NPI:1669234175
Name:COLLIER, MARIA ZANETA (LMT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ZANETA
Last Name:COLLIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:ZANETA
Other - Last Name:THREAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11891 CHARLIE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-3938
Mailing Address - Country:US
Mailing Address - Phone:904-697-8914
Mailing Address - Fax:
Practice Address - Street 1:4237 SALISBURY RD BLDG 1
Practice Address - Street 2:SUITE 107
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-206-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49986225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty