# PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023831047
- **Authorized official:** KRISTY MUSIC (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (877) 952-3815

## Contact information

- **Practice address:** 2400 HARBOR BLVD STE 7, PORT CHARLOTTE, FL 33952-5038
- **Practice address phone:** (941) 766-5099
- **Practice address fax:** (941) 766-4884
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-7000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/07/2024
- **Last updated:** 11/07/2024