Organization
TALLAHASSEE MEMORIAL HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBIN L MOSS (EXECUTIVE DIRECTOR)
(850) 431-6256
Entity
Organization
Contact information
Practice address
1549 S JEFFERSON ST, MONTICELLO, FL 32344-1651
(850) 997-0707
(850) 997-6833
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
01
—
24766E
BCBS GROUP NUMBER
FL
05
—
375270408
—
FL
05
—
660037901
—
FL
Enumeration date
05/09/2006
Last updated
01/28/2019
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