Burnt Store Family Medicine P L
NPI 1164739421 · Family Medicine Physician · Punta Gorda, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Burnt Store Family Medicine P L is a Family Medicine Physician organization in Punta Gorda, FL (NPI 1164739421).
Provider details
- NPI number
- 1164739421
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gordon Wang, Owner(941) 505-0974
- License
- ME0072508 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-09-08
- Last updated
- 2011-06-23
Frequently asked questions
- What is Burnt Store Family Medicine P L's NPI number?
- Burnt Store Family Medicine P L's National Provider Identifier (NPI) is 1164739421, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Burnt Store Family Medicine P L?
- Burnt Store Family Medicine P L is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Burnt Store Family Medicine P L located?
- Burnt Store Family Medicine P L's practice location on file with NPPES is 100 Madrid Blvd, Punta Gorda, FL 33950-7968.
- What is Burnt Store Family Medicine P L's phone number?
- The practice phone number listed in the NPPES registry for Burnt Store Family Medicine P L is (941) 505-0974.
- Does Burnt Store Family Medicine P L accept Medicare?
- Burnt Store Family Medicine P L is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Burnt Store Family Medicine P L?
- The authorized official listed on Burnt Store Family Medicine P L's NPPES record is Gordon Wang, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Burnt Store Family Medicine P L's NPI active?
- Yes — Burnt Store Family Medicine P L's NPI (1164739421) is active in the NPPES registry as of the last update on 2011-06-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.