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General NPI Number Information
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NPI Number | 1790040160
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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 | 07/11/2012
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 2633 CENTENNIAL BLVD STE 100
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City | TALLAHASSEE
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State | FL
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Zip | 32308-0606
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Country | US
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Telephone | 850-877-7387
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Fax | 850-656-3376
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Provider Business Mailing Address
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Address Line | 1607 SAINT JAMES CT STE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5352
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Country | US
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Telephone | 850-431-7021
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Fax | 850-431-6975
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBIN 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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State | FL
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