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Port Charlotte Hma Physician Management LLC

Geriatric Medicine (Internal Medicine) Physician in Port Charlotte, FL · enumerated 2021 · authorized official Jennifer Jackson, Sr Dir Prov Enrollment & Onboarding.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1295304822

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Registry record

Entity type Organization (Type 2)
Legal business name Port Charlotte Hma Physician Management LLC
Other name <Unavail>
Practice address 3508 Tamiami Trl, Port Charlotte, FL, 33952
Fax (941) 883-3320
Enumeration date Jun 18, 2021
Last updated in NPPES Mar 16, 2022

Taxonomy & classification

207RG0300X Geriatric Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jennifer Jackson
Title Sr Dir Prov Enrollment & Onboarding

Other identifiers

Identifier Type State Issuer
278507213 Medicaid FL -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Port Charlotte Hma Physician Management LLC?
The NPI for Port Charlotte Hma Physician Management LLC is 1295304822, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Port Charlotte Hma Physician Management LLC?
NPPES lists Jennifer Jackson (Sr Dir Prov Enrollment & Onboarding) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-03-16.