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General NPI Number Information
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NPI Number | 1346492527
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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 | 10/21/2008
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 1300 MICCOSUKEE RD ATTN: PALLIATIVE CARE/PASTORIAL SERVICES
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5054
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Country | US
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Telephone | 850-431-4671
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Fax | 850-431-6987
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Provider Business Mailing Address
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Address Line | 1309 THOMASVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32303-5607
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Country | US
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Telephone | 850-431-6380
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Fax | 850-431-6987
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROB L MOSS
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Credential |
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Telephone | 850-431-6256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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