Provider Demographics
NPI:1952514614
Name:COLLIER HEALTH SERVICES INC
Entity Type:Organization
Organization Name:COLLIER HEALTH SERVICES INC
Other - Org Name:CENTRAL NAPLES PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARAGONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-658-3035
Mailing Address - Street 1:3425 10TH ST N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3806
Mailing Address - Country:US
Mailing Address - Phone:239-262-3669
Mailing Address - Fax:239-262-2031
Practice Address - Street 1:3425 10TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3806
Practice Address - Country:US
Practice Address - Phone:239-262-3669
Practice Address - Fax:239-262-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101901Medicare Oscar/Certification