Organization Active NPI

Trillium Medical Group of Florida, Inc.

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1730390451
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRILLIUM MEDICAL GROUP OF FLORIDA, INC.
Practice address
1811 N Belcher Rd
Clearwater, FL 33765-1433
Phone
(800) 750-8103
Fax
(866) 788-0863
NPI assigned
May 24, 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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1811 N Belcher Rd
Clearwater, FL 33765-1433

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
34129OtherFLBCBS GROUP

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

1811 N Belcher Rd
Clearwater, FL 33765
Phone (727) 669-6449

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730390451",
    "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": "1811 N BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651433",
            "telephone_number": "800-750-8103",
            "fax_number": "866-788-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM MEDICAL GROUP OF FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "34129",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, 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.