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General NPI Number Information
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NPI Number | 1053364703
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Entity Type | Organization
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Legal Business Name | PORT CHARLOTTE HMA LLC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 2500 HARBOR BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5000
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Country | US
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Telephone | 941-766-4125
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Fax | 941-766-4140
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Provider Business Mailing Address
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Address Line | 2500 HARBOR BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5000
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Country | US
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Telephone | 941-766-4125
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Fax | 941-766-4140
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Authorized Official
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Title or Position | DIRECTOR
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Name | PAULA M LALOR
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Credential |
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Telephone | 629-215-3953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4340
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License Number State | FL
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