Unknown Individual – Family Medicine Physician, NPI 1659377117
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2852, Tamiami Trail, Port Charlotte, Charlotte County, Florida, 33952, United States
STE 6
PORT CHARLOTTE, FL 339525100
Phone: (941) 743-4445
Fax: (941) 743-4287
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33952)
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