Morningstar Medical Group
Nurse Practitioner in Port Charlotte, FL. Organization (NPI-2).
NPI number1124865571
StatusActive
Last updated in NPPESJun 18, 2025
Details
- NPI
- 1124865571
- Entity type
- Organization (NPI-2)
- Legal business name
- Morningstar Medical Group
- Organization subpart
- No
- Enumeration date
- Jul 12, 2024
- Certification date
- Jun 18, 2025
- Last updated
- Jun 18, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
1435 Collingswood Blvd Unit BPort Charlotte, FL 33948-1148
Phone 941-280-1020 · Fax 941-216-6935
Mailing address
1435 Collingswood Blvd Unit BPort Charlotte, FL 33948-1148
Phone 941-223-2695
Authorized official
Brandy Hauser
Owner/Ceo
9412232695
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