TRILLIUM MEDICAL GROUP OF FLORIDA NPI 1760693535

NPI Information

NPI: 1760693535
Provider Name: TRILLIUM MEDICAL GROUP OF FLORIDA
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
21827 STATE ROAD 54
LUTZ, FL
ZIP 33549
Phone: (727) 750-8103
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TRILLIUM MEDICAL GROUP OF FLORIDA is a rural health clinic center in Lutz, FL. TRILLIUM MEDICAL GROUP OF FLORIDA NPI is 1760693535. The provider is registered as an organization entity type.

The provider's business location address is:

21827 STATE ROAD 54
LUTZ, FL
ZIP 33549-924
Phone: (727) 750-8103
Fax: (866) 788-0863

The provider's authorized official is Bobby L Coates .
The authorized official title is President and has the following contact phone number (727) 403-5221.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	34129	OTHER	FLORIDA	BCBS GROUP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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