COLLIER HEALTH SERVICES INC (NPI# 1003065723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003065723 |
| Entity Type | Organization |
| Organization Name | COLLIER HEALTH SERVICES INC |
| Other Organization Name | CHS-UF PEDIATRIC DENTAL CENTER |
| Practice Address |
1454 Madison Ave W Immokalee FL 34142-2200 |
| Mailing Address |
7007 Lely Cultural Pkwy Edison College Building L Naples FL 34113-8976 |
| Practice Telephone | 2396583064 |
| Practice Fax Number | 2396583175 |
| Mailing Telephone | 2397753052 |
| Mailing Fax Number | 2397757035 |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2009-11-05 |
| Authorized Official Name | SANDRA STEELE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2396583003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| N | 126800000X | Dental Assistant | Dental Providers | ||
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| CHS-UF Pediatric Dental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073707741 | Collier Health Services Inc | Clinic/Center | 1749 Heritage Trl # 801, Naples, FL 34112-7591 | 2007-09-05 |
| 1952516866 | Collier Health Services Inc | Dentist | 5038 Coronado Pkwy, Naples, FL 34116-6950 | 2007-05-14 |
| 1851505200 | Collier Health Services Inc | Clinic/Center | 6350 Davis Blvd # 1001, Naples, FL 34104-5323 | 2007-05-09 |
| 1508079245 | Collier Health Services Inc | Clinic/Center | 508 N 9th St, Suite 142, Immokalee, FL 34142-3146 | 2007-05-08 |
| 1528271012 | Collier Health Services Inc | Clinic/Center | 12655 Collier Blvd, Naples, FL 34116-4005 | 2007-05-08 |
| 1679124010 | Collier Health Services Inc | General Practice | 12655 Collier Blvd, Naples, FL 34116-4005 | 2019-09-26 |
| 1174174783 | Collier Health Services Inc | Clinic/Center | 12655 Collier Blvd, Naples, FL 34116-4005 | 2019-09-25 |
| 1972158632 | Collier Health Services Inc | Pharmacy | 12655 Collier Blvd, Naples, FL 34116 | 2019-08-08 |
| 1063793214 | Collier Health Services Inc | Family Medicine | 1284 Creekside St, Suite #101, Naples, FL 34108-1949 | 2011-09-01 |
| 1376823922 | Collier Health Services Inc | Clinic/Center | 1284 Creekside St, Suite #101, Naples, FL 34108-1949 | 2011-08-26 |
| Street Address |
1454 MADISON AVE W |
| City | IMMOKALEE |
| State | FL |
| Zip Code | 34142-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083617484 | Van Keith Riley | Dentist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2005-05-31 |
| 1467071076 | Riha Wadhwa | Student in an Organized Health Care Education/Training Program | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2020-04-14 |
| 1558821918 | Ilmary Enid Arce Febles | Dentist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2019-03-21 |
| 1578047221 | Frances Sanchez Duverge | Psychologist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2018-09-19 |
| 1043716996 | Anthony Tyler Riggio | Dentist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2018-03-31 |
| 1891210399 | Jean Kesnold Mesidor | Psychologist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2017-08-07 |
| 1952852758 | Christell Sanchez | Dental Hygienist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2016-10-18 |
| 1740731447 | Paul Beingolea | Dental Hygienist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2016-10-18 |
| 1093266892 | Olga Guerrero | Dental Hygienist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2016-10-18 |
| 1184175986 | Orayna Perez | Dental Hygienist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2016-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619432622 | Gabriels House of Care Fl. LLC | Acupuncturist | 212 South First St., Immokalee, FL 34142 | 2019-02-04 |
| 1851662472 | Seminole Tribe of Florida | Clinic/Center | 1120 S. First Street, Immokalee, FL 34142 | 2012-01-13 |
| 1881849826 | Michael Kane | Dentist | 1013 W. Main St., Unit 6a, Immokalee, FL 34142 | 2008-11-18 |
| 1699870485 | Jane J Darien | Social Worker | 425 North First St, Immokalee, FL 34142 | 2006-09-14 |
| 1659873891 | Dayna Sue Shull | Specialist/Technologist | 5050 Ave Maria Blvd, Ave Maria, FL 34142 | 2018-03-04 |
| 1457881922 | Immokalee Dental P.a. | Dentist | 1013 W. Main St., Unit 6a, Immokalee, FL 34142 | 2017-06-15 |
| 1063687838 | Alexandra Bianca Sarac | Pediatrics | 1441 Heritage Blvd, Immokalee, FL 34142 | 2008-04-23 |
| 1215262977 | Mid State Mental Health Assessment Inc | Psychologist | 7052 Annunciation Circle, Suite 329, Ave Maria, FL 34142-0000 | 2009-10-13 |
| 1194343194 | Laury Garcia | Social Worker | 3511 Carson Lakes Cir, Immokalee, FL 34142-2092 | 2020-07-07 |
| 1558399550 | Georges Etienne Quesnel | Obstetrics & Gynecology | Marion E Fether Medical Center, 1454 Madison Ave. W, Immokalee, FL 34142-2200 | 2006-06-29 |
| Find all providers in zip 34142 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053544692 | Jerry Klein | Dentist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2009-08-31 |
| 1063547545 | Rose Martine Gedeon | Dentist | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113296 | Pediatric Dental Center of Gardens Inc | Dentist | 18244 Nw 27th Ave, Miami Gardens, FL 33056-3501 | 2020-10-27 |
| 1205446598 | Harp Pediatric Dentistry | Dentist | 31067 Us Highway 19 N, Palm Harbor, FL 34684-4416 | 2020-08-03 |
| 1043829377 | Little Champions Pediatric Dentistry | Dentist | 1330 Sw 22nd St Ste 406, Miami, FL 33145-2945 | 2020-07-22 |
| 1710595509 | Bright Smiles Pediatric Dentistry Nassau LLC | Dentist | 960135 Gateway Blvd, Fernandina Beach, FL 32034-9120 | 2020-07-17 |
| 1578180097 | Juliana Grace Fitzgerald | Dentist | 7505 Grand Lely Dr Bldg 1, Naples, FL 34113-1753 | 2020-06-30 |
| 1861012569 | Toni-marie Small | Dentist | 12625 76th Rd N, West Palm Beach, FL 33412-2259 | 2020-04-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1114573086 | Kids Dentist LLC | Dentist | 8058 W Mcnab Rd, North Lauderdale, FL 33068-4254 | 2019-08-15 |
| 1558915157 | Dentistry for Children of Florida, Pllc | Dentist | 3021 Airport Rd N Ste 203, Naples, FL 34105-3077 | 2019-07-31 |
| 1528620937 | Catherine Jane Graham | Dentist | 1395 Center Dr Rm D11-6, Gainesville, FL 32610-3006 | 2019-07-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.