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General NPI Number Information
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NPI Number | 1063044188
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Entity Type | Organization
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Legal Business Name | TRANSITIONAL MEDICAL MANAGEMENT, LLC
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 12957 TURTLE COVE TRL
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-6913
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Country | US
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Telephone | 239-247-2118
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Fax | 239-206-8289
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Provider Business Mailing Address
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Address Line | 12957 TURTLE COVE TRL
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-6913
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Country | US
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Telephone | 239-247-2118
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Fax | 239-206-8289
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JEANNE BEAULIEU
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Credential |
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Telephone | 239-247-2118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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