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Organization

GULF COAST HMA PHYSICIAN MANAGEMENT LLC

Active
Other names
Gulf Coast Medical Group-Sarasota Primary Care, 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
8383 S TAMIAMI TRL UNIT 115, SARASOTA, FL 34238-2901
(941) 244-9430
(941) 244-9437
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
277033414
FL
Enumeration date
06/21/2021
Last updated
03/14/2022
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