PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC NPI 1659039311

NPI Information

NPI: 1659039311
Provider Name: PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC

Doing Business As: PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
2400 HARBOR BLVD STE 7
PORT CHARLOTTE, FL
ZIP 33952
Phone: (941) 766-5099
Get Directions

PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC is a vascular surgery surgery in Port Charlotte, FL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC NPI is 1659039311. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Port Charlotte Hma Physician Management Llc.

The provider's business location address is:

2400 HARBOR BLVD STE 7
PORT CHARLOTTE, FL
ZIP 33952-038
Phone: (941) 766-5099
Fax: (941) 766-4884

The provider's authorized official is Jennifer L Jackson .
The authorized official title is Sr Dir Prov Enrollment & Onboarding and has the following contact phone number (615) 465-3334.

The enumeration date for this NPI number is 11/30/2021 and was last updated on 5/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207RG0100X	Internal Medicine	Gastroenterology	No
2	363LA2100X	Nurse Practitioner	Acute Care	No
3	2086S0129X	Surgery	Vascular Surgery	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PENDING	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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