| Port Charlotte Hma Physician Management Llc | |
|
713 E Marion Ave Ste 121 Punta Gorda FL 33950-3862 | |
| (941) 833-1760 | |
| (941) 205-3374 |
| Full Name | Port Charlotte Hma Physician Management Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 713 E Marion Ave Ste 121, Punta Gorda, Florida |
| Authorized Official Name and Position | Kristina Music (DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Charlotte Hma Physician Management Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7211 | Port Charlotte Hma Physician Management Llc 713 E Marion Ave Ste 121 Punta Gorda FL 33950-3862 Ph: (941) 833-1760 |
| NPI Number | 1750040598 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 08/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750040598 | NPI | - | NPPES |
| 278507222 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208600000X | Surgery | (* (Not Available)) | Secondary |
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