Organization
PUNTA GORDA HMA LLC
Active
Other names
Shorepoint Behavioral Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
733 E OLYMPIA AVE, PUNTA GORDA, FL 33950-3841
(941) 637-2474
Mailing address
809 E MARION AVE, PUNTA GORDA, FL 33950-3819
(941) 639-3131
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010027700
—
FL
01
—
529
BLUE CROSS
FL
Enumeration date
06/05/2006
Last updated
12/14/2021
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