| Trillium Medical Group Of Florida | |
|
21827 State Road 54 Lutz FL 33549-6924 | |
| (727) 750-8103 | |
| (866) 788-0863 |
| Full Name | Trillium Medical Group Of Florida |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 21827 State Road 54, Lutz, Florida |
| Authorized Official Name and Position | Bobby L Coates (PRESIDENT) |
| Authorized Official Contact | 7274035221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trillium Medical Group Of Florida Po Box 23788 Tampa FL 33623-3788 Ph: (800) 750-8103 | Trillium Medical Group Of Florida 21827 State Road 54 Lutz FL 33549-6924 Ph: (727) 750-8103 |
| NPI Number | 1760693535 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760693535 | NPI | - | NPPES |
| 34129 | Other | FL | BCBS GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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