# GULF COAST HMA PHYSICIAN MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gulf Coast Medical Group-Sarasota Primary Care, Gulf Coast HMA Physician Management LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346819729
- **Authorized official:** JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 8383 S TAMIAMI TRL UNIT 115, SARASOTA, FL 34238-2901
- **Practice address phone:** (941) 244-9430
- **Practice address fax:** (941) 244-9437
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-7211
- **Mailing address fax:** (615) 628-6877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/21/2021
- **Last updated:** 03/14/2022