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Organization

GULF COAST HMA PHYSICIAN MANAGEMENT LLC

Active
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Organization

GULF COAST HMA PHYSICIAN MANAGEMENT LLC

Active
Parent organization
HEALTH MANAGEMENT ASSOCIATES, INC
Other names
Gulf Coast Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
HEALTH MANAGEMENT ASSOCIATES, INC
Authorized official
JENNIFER L JACKSON (SR. DIRECTOR PROVIDER ENROLLMENT)
(615) 465-3334
Entity
Organization

Contact information

Practice address
1101 TAMIAMI TRL S, SUITE 101, VENICE, FL 34285-4133
(941) 480-2831
(941) 480-2820
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RP1001X
Pulmonary Disease Physician
207T00000X
Neurological Surgery Physician
207V00000X
Obstetrics & Gynecology Physician
208600000X
Surgery Physician
208D00000X
General Practice Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
94784
BCBS GROUP PROVIDER NUMBE
FL
Enumeration date
05/12/2006
Last updated
03/14/2022
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