Port Charlotte Hma Physician Management LLC

NPI #1124697743 in Arcadia, Florida

Provider Information

NPI Number: 1124697743
Entity Type: Organization
Organization Name: Port Charlotte Hma Physician Management LLC
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Jun 18, 2021
Last Updated: Mar 16, 2022

Practice Location

Address: 1012 N MILLS AVE
City: Arcadia
State: Florida
ZIP Code: 34266-8811
Phone: (941) 766-0400

Authorized Official

Name: JENNIFER L JACKSON
Title: SR DIR PROV ENROLLMENT & ONBOARDING
Phone: (615) 465-3334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Obstetrics & Gynecology — Obstetrics & Gynecology	363LX0001X
Obstetrics & Gynecology	207V00000X	Primary

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