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Organization
GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Active
Organization
GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Bayfronthealth Rehab, Gulf Coast HMA Physician Management LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
900 PINE ST STE 222, ENGLEWOOD, FL 34223-4458
(941) 486-6420
(641) 486-6419
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207VG0400X
Gynecology Physician
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277033435
—
FL
Enumeration date
07/16/2021
Last updated
03/14/2022
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