# PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Port Charlotte HMA Physician Management LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831866110
- **Authorized official:** KRISTINA MUSIC (DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (877) 892-9815

## Contact information

- **Practice address:** 18659 TAMIAMI TRL, NORTH PORT, FL 34287-7388
- **Practice address phone:** (941) 423-5035
- **Practice address fax:** (941) 423-5034
- **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 |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/25/2021
- **Last updated:** 11/15/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PENDING | — | FL |