Active NPI
Trillium Medical Group of Florida, Inc.
- Family Medicine Physician
- Clearwater, FL
National Provider Identifier
1730390451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34129 | Other | FL | BCBS GROUP |
National Provider Directory
National Provider Directory- Tax ID family
- Trillium Medical Group of Florida
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Physician
- Lutz, FL
- NPI 1285835322
-
- Rural Health Clinic/Center
- Lutz, FL
- NPI 1760693535
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.