NPIMap

Organization Active NPI

Trillium Medical Group of Florida

  • General Practice Physician
  • Lutz, FL
National Provider Identifier
1285835322
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
TRILLIUM MEDICAL GROUP OF FLORIDA
Practice address
1843 Collier Pkwy
Lutz, FL 33549-8718
Phone
(800) 750-8103
Fax
(866) 788-0863
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bobby L Coates
Title
President
Phone
(727) 403-5221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1843 Collier Pkwy
Lutz, FL 33549-8718

Mailing address

PO Box 23788
Tampa, FL 33623-3788
Phone (800) 750-8103

National Provider Directory

National Provider Directory
Tax ID family
Trillium Medical Group of Florida3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1843 Collier Pkwy
Lutz, FL 33549
Phone (800) 750-8103

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285835322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23788",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336233788",
            "telephone_number": "800-750-8103",
            "fax_number": "866-788-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 COLLIER PKWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335498718",
            "telephone_number": "800-750-8103",
            "fax_number": "866-788-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM MEDICAL GROUP OF FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COATES",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-403-5221"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.