Organization
PUNTA GORDA HMA, LLC
Active
Other names
Bayfront Health Home Infusion
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
809 E MARION AVE, PUNTA GORDA, FL 33950-3819
(941) 637-2519
(941) 637-2565
Mailing address
809 E MARION AVE, PUNTA GORDA, FL 33950-3819
(941) 637-2519
(941) 637-2565
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6728680001
MEDICARE
FL
Enumeration date
11/09/2012
Last updated
10/10/2019
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