Healthcare Provider Details

I. General information

NPI: 1073483061
Provider Name (Legal Business Name): PCP - HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16954 TOLEDO BLADE BLVD
PORT CHARLOTTE FL
33954-1674
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 941-564-9009
  • Fax: 941-629-6805
Mailing address:
  • Phone: 914-564-1038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDRA MACSWEENEY
Title or Position: OWNER
Credential: FNP
Phone: 914-564-1038