Organization
PORT CHARLOTTE HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Port Charlotte 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
3440 TAMIAMI TRL UNIT 1, PORT CHARLOTTE, FL 33952-8134
(941) 258-9500
(941) 258-9501
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
08/25/2021
Last updated
07/25/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us