Healthcare Provider Details

I. General information

NPI: 1063983138
Provider Name (Legal Business Name): TRANSITIONAL CARE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 BEDFORD DR STE B
MELBOURNE FL
32940-1986
US

IV. Provider business mailing address

1341 BEDFORD DR STE B
MELBOURNE FL
32940-1986
US

V. Phone/Fax

Practice location:
  • Phone: 321-622-8031
  • Fax: 321-610-7484
Mailing address:
  • Phone: 321-622-8031
  • Fax: 321-610-7484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN M GIORGIANNI
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: DO
Phone: 321-622-8031