Three Rivers Medical Inc.

Organization Active NPI Family Nurse Practitioner · Branford, FL

NPI 1710049671 · NPPES record last updated Feb 4, 2010

Key facts

NPI
1710049671
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
2934442 (FL)
Legal business name
THREE RIVERS MEDICAL INC.
Practice address
208 Suwannee Ave NW
Branford, FL 32008-3265
Phone
(386) 935-1607
Fax
(386) 935-1667
NPI assigned
Dec 15, 2006
Organization subpart
No

Authorized official

Name
Ms. Peggy L Maloney
Title
Practice Manager
Phone
(386) 935-1607

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 2

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X 2934442 FL Yes

Addresses

Primary practice location

208 Suwannee Ave NW
Branford, FL 32008-3265

Mailing address

208 Suwannee Ave NW
Branford, FL 32008-3265
Phone (386) 935-1607

Other identifiers

IdentifierTypeStateIssuer
303822000MedicaidFL

Other providers in Branford, FL

All providers in Branford, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.