Split Mountain Emergency Physicians LLC
Emergency Medicine in Port Charlotte, FL. Organization (NPI-2).
NPI number1801532007
StatusActive
Last updated in NPPESMay 10, 2022
Details
- NPI
- 1801532007
- Entity type
- Organization (NPI-2)
- Legal business name
- Split Mountain Emergency Physicians LLC
- Organization subpart
- No
- Enumeration date
- May 10, 2022
- Certification date
- Apr 26, 2022
- Last updated
- May 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | – | Yes |
Practice location
105 Tamiami TrailPort Charlotte, FL 33953
Phone 941-629-1181
Mailing address
5565 Centerview Dr Ste 107Raleigh, NC 27606-3563
Phone 973-251-1132
Authorized official
Kathleen Kondas
Officer
9732511132
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