| Tgpn M1 Llc | |
|
3893 Military Trl Ste 1 Jupiter FL 33458-2936 | |
| (561) 559-0955 | |
| (561) 621-9669 |
| Full Name | Tgpn M1 Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3893 Military Trl Ste 1, Jupiter, Florida |
| Authorized Official Name and Position | Abraham Schwarzberg (PRESIDENT) |
| Authorized Official Contact | 5612533980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tgpn M1 Llc 6415 Lake Worth Rd Ste 102 Greenacres FL 33463-3009 Ph: (561) 559-0955 | Tgpn M1 Llc 3893 Military Trl Ste 1 Jupiter FL 33458-2936 Ph: (561) 559-0955 |
| NPI Number | 1225747827 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 09/11/2023 |
| Medicare PECOS PAC ID | 3375912371 |
|---|---|
| Medicare Enrollment ID | O20221214001775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225747827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Laurie P Rothman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093772972 PECOS PAC ID: 9931133071 Enrollment ID: I20050919000922 |
| Provider Name | Kymberlee A Coffindaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073057618 PECOS PAC ID: 8224397997 Enrollment ID: I20180125003089 |
| Provider Name | Marie Holt Cupit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689627895 PECOS PAC ID: 4082070297 Enrollment ID: I20230512002597 |
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