| Harborside Internal Medicine Pa | |
|
522 E Marion Ave Punta Gorda FL 33950-3875 | |
| (941) 637-1119 | |
| Not Available |
| Full Name | Harborside Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 522 E Marion Ave, Punta Gorda, Florida |
| Authorized Official Name and Position | Timothy A Janz (PRESIDENT) |
| Authorized Official Contact | 9416371119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harborside Internal Medicine Pa 522 E Marion Ave Punta Gorda FL 33950-3814 Ph: (941) 637-1119 | Harborside Internal Medicine Pa 522 E Marion Ave Punta Gorda FL 33950-3875 Ph: (941) 637-1119 |
| NPI Number | 1386664621 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2163498023 |
|---|---|
| Medicare Enrollment ID | O20040902000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386664621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME71373 (Florida) | Primary |
| 207R00000X | Internal Medicine | ME48819 (Florida) | Secondary |
| Provider Name | Timothy A Janz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659342004 PECOS PAC ID: 3173599040 Enrollment ID: I20101129000019 |
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