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Contact Information

GULF COAST HMA PHYSICIAN MANAGEMENT LLC
333 TAMIAMI TRL S STE 183
VENICE, FL34285-2426
 Phone: 941-375-3006
 Fax: 941-218-4825
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for GULF COAST HMA PHYSICIAN MANAGEMENT LLC

NPI # 1427620988
LBN Legal business name GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Authorized official JENNIFER JACKSON - (SR DIR PROV ENROLLMENT & ONBOARDING)
Entity Organization
Organization subpart 1 No
Enumeration date 07/14/2021
Last updated 03/15/2022 - About 4 years ago
Identifiers
FL Medicaid 277033413
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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