Tallahassee Memorial Healthcare Inc
Organization Active NPI Oral & Maxillofacial Surgery (D.M.D.) · Tallahassee, FL
NPI 1578075503 · NPPES record last updated Jan 28, 2019
Key facts
- NPI
- 1578075503
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.) 204E00000X
- Legal business name
- TALLAHASSEE MEMORIAL HEALTHCARE INC
- Practice address
- 2929 Capital Medical Blvd
Tallahassee, FL 32308-4407 - Phone
- (850) 431-6725
- Fax
- (850) 431-6859
- NPI assigned
- Oct 31, 2017
- Organization subpart
- No
Authorized official
- Name
- Robin L Moss
- Title
- Executive Director
- Phone
- (850) 431-6256
Other NPIs on the same Medicare enrollment 39
Corporate family (same tax ID) 37
Practitioners 1
-
Ricardo M Ortiz, DMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031222000279 | FL | Part B Supplier - Clinic/Group Practice | 6103724778 |
Receives reassigned benefits from 702 practitioners 39 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tallahassee, FL; Blountstown, FL; Chipley, FL; Crawfordville, FL; Madison, FL; Marianna, FL; Monticello, FL; Panama City Beach, FL… |
National Provider Directory
- Tax ID family
- Tall Mem Psychiatric G
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) |
204E00000X | Yes | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
2929 Capital Medical Blvd
Tallahassee, FL 32308-4407
Mailing address
1607 Saint James CT Ste 1
Tallahassee, FL 32308-5352
Phone (850) 431-7021
Other names
- TMH Physician Partners Oral Maxillofacial Specialists
Other providers in Tallahassee, FL
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
- Tallahassee Memorial Healthcare Inc
All providers in Tallahassee, FL · Oral & Maxillofacial Surgery (D.M.D.) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.