# PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC
- **Other names:** Shorepoint Obstetrics and Gynecology- RHC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730672379
- **Legal business name:** PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC
- **Authorized official:** JENNIFER L JACKSON (SR DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 1012 N MILLS AVE, ARCADIA, FL 34266-8811
- **Practice address phone:** (941) 766-0400
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/08/2018
- **Last updated:** 03/18/2022