Organization
TALLAHASSEE MEMORIAL HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBIN L MOSS (EXECUTIVE DIRECTOR)
(850) 431-6259
Entity
Organization
Contact information
Practice address
17808 NE CHARLIE JOHNS ST, BLOUNTSTOWN, FL 32424-1052
(850) 674-4524
(850) 674-2300
Mailing address
1607 SAINT JAMES CT STE 1, TALLAHASSEE, FL 32308-5352
(850) 431-7021
(850) 431-6975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375270403
—
FL
05
—
6600379-00
—
FL
Enumeration date
05/09/2006
Last updated
01/28/2019
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