Organization Active NPI

Charlotte Integrative Medicine

  • Family Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1306244520
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
PA9108212 Issued in FL
Legal business name
CHARLOTTE INTEGRATIVE MEDICINE
Practice address
3005 Caring Way
Suite 1
Port Charlotte, FL 33952-5304
Phone
(941) 629-3500
Fax
(941) 629-3100
NPI assigned
Dec 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Veronica Alessandro, ARNP
Title
Owner
Phone
(941) 629-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X PA9108212 FL Primary

Addresses

Primary practice location

3005 Caring Way
Suite 1
Port Charlotte, FL 33952-5304

Mailing address

3005 Caring Way
Suite 1
Port Charlotte, FL 33952-5304
Phone (941) 629-3500

Other identifiers 1

IdentifierTypeStateIssuer
009ABOtherFLBCBS FL

National Provider Directory

National Provider Directory

Locations

2295 Shreve St
Punta Gorda, FL 33950
Phone (941) 575-9390

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1306244520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 CARING WAY",
            "address_2": "SUITE 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525304",
            "telephone_number": "941-629-3500",
            "fax_number": "941-629-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 CARING WAY",
            "address_2": "SUITE 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525304",
            "telephone_number": "941-629-3500",
            "fax_number": "941-629-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "ALESSANDRO",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-629-3500",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "PA9108212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "009AB",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.