Trillium Medical Group of Florida

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

TRILLIUM MEDICAL GROUP OF FLORIDA

Practice address

21827 State Road 54
Lutz, FL 33549-6924

Phone

(727) 750-8103

Fax

(866) 788-0863

NPI assigned

May 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 1

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.

• Trillium Medical Group of Florida

  • General Practice Physician
  • Lutz, FL
  • NPI 1285835322
  NPD tax ID
• Trillium Medical Group of Florida, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1730390451
  NPD tax ID

Locations

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": "1760693535",
    "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": "21827 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496924",
            "telephone_number": "727-750-8103",
            "fax_number": "866-788-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM MEDICAL GROUP OF FLORIDA",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "34129",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Transitional Wound Care LLC
• Kara Travieso
• Brigid Noelle Treverton-Strenges, PHD
• Stephanie Therese Trexler, M.D.
• Trillium Medical Group of Florida
• Ashley Trivino, DNP
• Judith Loney Trotman, ARNP
• TRSC Legacy Inc
• Alexandria Stelogeannis Truluck, PT, DPT
• Jasmin Trump

• Rural Health Clinic/Center in Lutz, FL
• Providers in Lutz, FL by specialty
• Rural Health Clinic/Center in Florida

• 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.