Organization · NPI-2

360 Primary Care LLC

Internal Medicine · Port Charlotte, FL

NPI number1427901164
StatusActive
Last updated in NPPESOct 19, 2026

Details

NPI
1427901164
Entity type
Organization (NPI-2)
Legal business name
360 Primary Care LLC
Organization subpart
No
Enumeration date
Feb 20, 2026
Certification date
Oct 19, 2026
Last updated
Oct 19, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

2484 Caring Way Unit F
Port Charlotte, FL 33952-5306

Phone 941-218-0544 · Fax 941-235-8816

Mailing address

2484 Caring Way Unit F
Port Charlotte, FL 33952-5306

Phone 941-218-0544 · Fax 941-235-8816

Authorized official

Jake R Hager
Owner
7013512566

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine providers in Port Charlotte, FL