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Organization
THREE RIVERS MEDICAL INC.
Active
Organization
THREE RIVERS MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PEGGY L MALONEY (PRACTICE MANAGER)
(386) 935-1607
Entity
Organization
Contact information
Practice address
208 SUWANNEE AVE NW, BRANFORD, FL 32008-3265
(386) 935-1607
(386) 935-1667
Mailing address
208 SUWANNEE AVE NW, BRANFORD, FL 32008-3265
(386) 935-1607
(386) 935-1667
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2934442
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303822000
—
FL
Enumeration date
12/15/2006
Last updated
02/04/2010
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