MEDICARE: THOROUGH MED LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1346974599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOROUGH MED LLC

Provider Business Mailing Address
First Line	:	5353 NW MIMS CT
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2780
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 SE HILLMOOR DR STE B-109
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-7550
Country	:	US
Telephone Number	:	772-337-9473
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MELSAH RILEY-HAZEL
Credential	:
Telephone Number	:	772-377-9473

Provider Enumeration Date	:	07/13/2022
Last Update Date	:	07/13/2022

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Directions to “THOROUGH MED LLC ” Practice Location

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