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General NPI Number Information
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NPI Number | 1033512462
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Entity Type | Organization
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Legal Business Name | TMMD, LLC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 1831 N BELCHER RD SUITE C-3
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City | CLEARWATER
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State | FL
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Zip | 33765-1449
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Country | US
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Telephone | 727-510-8464
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4363
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City | SEMINOLE
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State | FL
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Zip | 33775-4363
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Country | US
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Telephone | 727-510-8464
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRINETTE MOSS
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Credential | M.D.
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Telephone | 727-510-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0079327
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License Number State | FL
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