Provider Demographics
NPI:1063044188
Name:TRANSITIONAL MEDICAL MANAGEMENT, LLC
Entity Type:Organization
Organization Name:TRANSITIONAL MEDICAL MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAULIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-247-2118
Mailing Address - Street 1:12957 TURTLE COVE TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-6913
Mailing Address - Country:US
Mailing Address - Phone:239-247-2118
Mailing Address - Fax:239-206-8289
Practice Address - Street 1:12957 TURTLE COVE TRL
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-6913
Practice Address - Country:US
Practice Address - Phone:239-247-2118
Practice Address - Fax:239-206-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty