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NPI 1306369657

NPI 1306369657 : TALLAHASSEE MEMORIAL HEALTHCARE INC : MADISON, FL

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General NPI Number Information
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    NPI Number           |    1306369657
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    Entity Type          |    Organization 
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    Legal Business Name  |    TALLAHASSEE MEMORIAL HEALTHCARE INC 
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Dates
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    Enumeration Date     |    07/19/2017
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    Last Update Date     |    01/09/2025
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Provider Practice Location Address
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    Address Line         |    224 NW CRANE AVE 
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    City                 |    MADISON
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    State                |    FL
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    Zip                  |    32340-1400
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    Country              |    US
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    Telephone            |    850-973-2271
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    Fax                  |    850-973-2818
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Provider Business Mailing Address
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    Address Line         |    1300 MEDICAL DRIVE BILLING DEPARTMENT
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    City                 |    TALLAHASSEE
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    State                |    FL
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    Zip                  |    32308-4622
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    Country              |    US
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    Telephone            |    850-216-0100
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    Fax                  |    850-216-0180
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     JENNIFER  PARKS 
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    Credential           |    
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    Telephone            |    850-431-6234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    
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    License Number State |    
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