Provider Demographics
NPI:1871543512
Name:COLLIER NEUROLOGIC SPECIALISTS LLC
Entity type:Organization
Organization Name:COLLIER NEUROLOGIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-262-8971
Mailing Address - Street 1:3200 BAILEY LN STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-8523
Mailing Address - Country:US
Mailing Address - Phone:239-262-1721
Mailing Address - Fax:239-262-1045
Practice Address - Street 1:3200 BAILEY LN STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8523
Practice Address - Country:US
Practice Address - Phone:239-262-8971
Practice Address - Fax:239-262-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252255100Medicaid
FL252255100Medicaid
FL252255100Medicaid
FL4855080001Medicare NSC
FL99113AMedicare PIN