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2525 Harbor Blvd #104 Port Charlotte FL 33952-5317 | |
| (941) 629-5757 | |
| (941) 629-7404 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 2525 Harbor Blvd, Port Charlotte, Florida |
| Authorized Official Name and Position | David E Novak (ADMINISTRATOR) |
| Authorized Official Contact | 9416295757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2525 Harbor Blvd #104 Port Charlotte FL 33952-5317 Ph: (941) 629-5757 | 2525 Harbor Blvd #104 Port Charlotte FL 33952-5317 Ph: (941) 629-5757 |
| NPI Number | 1851339535 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 08/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851339535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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