| Charlotte Harbor Wellness P A | |
|
2811 Tamiami Trl Port Charlotte FL 33952-5173 | |
| (941) 613-1919 | |
| (941) 613-4077 |
| Full Name | Charlotte Harbor Wellness P A |
|---|---|
| Speciality | Internal Medicine |
| Location | 2811 Tamiami Trl, Port Charlotte, Florida |
| Authorized Official Name and Position | Tetyana Metyk (OWNER) |
| Authorized Official Contact | 9416131919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charlotte Harbor Wellness P A 3191 Harbor Blvd Ste D Port Charlotte FL 33952-6755 Ph: (941) 613-1919 | Charlotte Harbor Wellness P A 2811 Tamiami Trl Port Charlotte FL 33952-5173 Ph: (941) 613-1919 |
| NPI Number | 1215613419 |
|---|---|
| Provider Enumeration Date | 06/23/2023 |
| Last Update Date | 01/09/2024 |
| Medicare PECOS PAC ID | 6507228368 |
|---|---|
| Medicare Enrollment ID | O20230811000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215613419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Tetyana Metyk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528354255 PECOS PAC ID: 2163667122 Enrollment ID: I20140617001841 |
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