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
KRISTINA MUSIC (DIRECTOR PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
18659 TAMIAMI TRL, NORTH PORT, FL 34287-7388
(941) 423-5035
(941) 423-5034
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
08/25/2021
Last updated
11/15/2023
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