Provider Demographics
NPI:1164060018
Name:THOROUGH MED LLC
Entity Type:Organization
Organization Name:THOROUGH MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELSAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY-HAZEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-543-7790
Mailing Address - Street 1:5353 NW MIMS CT
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2780
Mailing Address - Country:US
Mailing Address - Phone:561-543-7790
Mailing Address - Fax:
Practice Address - Street 1:1801 SE HILLMOOR DR STE B-109
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7550
Practice Address - Country:US
Practice Address - Phone:772-337-9473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization