NPIMap

Organization Active NPI

Punta Gorda Hma Physician Management LLC

Doing business as Charlotte Harbor Cardiac Surgical Associates

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Punta Gorda, FL
National Provider Identifier
1063719318
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
PUNTA GORDA HMA PHYSICIAN MANAGEMENT LLC
Doing business as
Charlotte Harbor Cardiac Surgical Associates
Practice address
713 E Marion Ave
Suite 133
Punta Gorda, FL 33950-3872
Phone
(941) 639-6616
Fax
(941) 639-1716
NPI assigned
Feb 23, 2011
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH MANAGEMENT ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jennifer L Jackson
Title
Senior Director Provider Enrollment
Phone
(615) 465-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

713 E Marion Ave
Suite 133
Punta Gorda, FL 33950-3872

Mailing address

5811 Pelican Bay Blvd
Suite 500
Naples, FL 34108-2733
Phone (239) 598-3131

Other names 1

  • Charlotte Harbor Cardiac Surgical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bayfront Health Medical Group Psychiatry6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1063719318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 PELICAN BAY BLVD",
            "address_2": "SUITE 500",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082733",
            "telephone_number": "239-598-3131",
            "fax_number": "239-592-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 E MARION AVE",
            "address_2": "SUITE 133",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503872",
            "telephone_number": "941-639-6616",
            "fax_number": "941-639-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUNTA GORDA HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH MANAGEMENT ASSOCIATES, INC.",
        "enumeration_date": "2011-02-23",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-3334",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlotte Harbor Cardiac Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Charlotte Harbor Cardiac Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Punta Gorda, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.