| 360 Primary Care LLC | |
|
2400 Harbor Blvd Ste 11 Port Charlotte FL 33952-5038 | |
| (941) 218-0544 | |
| Not Available |
| Full Name | 360 Primary Care LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2400 Harbor Blvd Ste 11, Port Charlotte, Florida |
| Authorized Official Name and Position | Jake R Hager (OWNER) |
| Authorized Official Contact | 7013512566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Primary Care LLC 2400 Harbor Blvd Ste 11 Port Charlotte FL 33952-5038 | 360 Primary Care LLC 2400 Harbor Blvd Ste 11 Port Charlotte FL 33952-5038 Ph: (941) 218-0544 |
| NPI Number | 1427901164 |
|---|---|
| Provider Enumeration Date | 02/20/2026 |
| Last Update Date | 02/20/2026 |
| Certification Date | 02/20/2026 |
| Medicare PECOS PAC ID | 9436622453 |
|---|---|
| Medicare Enrollment ID | O20260622002960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427901164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Jake Richard Hager |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588892053 PECOS PAC ID: 3971752486 Enrollment ID: I20150903001729 |
| Provider Name | Binit Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053990044 PECOS PAC ID: 3971906330 Enrollment ID: I20240621000803 |
| Provider Name | Nikul Dilip Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023759230 PECOS PAC ID: 4082127618 Enrollment ID: I20250627001501 |
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