OrganizationActive
Collier Boulevard Hma Physician Management LLC
NPI 1710555818 · General Practice Physician · Estero, FL
Provider details
- NPI number
- 1710555818
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Jackson, Sr Dir Prov Enrollment & Onboarding(615) 465-3334
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
24231 Walden Center Dr Ste 160
Estero, FL 34134-5011
Phone: (239) 348-4221
Fax: (239) 348-4529
Street-level locationGet directions
Mailing address
Po Box 689022
Franklin, TN 37068-9022
Other names (DBA / former)
- Doing business as
- Collier Boulevard Hma Physician Management LLC
- Doing business as
- Collier Boulevard Hma Physician Management LLC
Registry dates
- Enumerated
- 2021-06-15
- Last updated
- 2022-03-14
- Certified
- 2022-03-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.