Provider Demographics
NPI:1376059352
Name:TNT MEDICAL SURGICAL GROUP INC
Entity Type:Organization
Organization Name:TNT MEDICAL SURGICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:216-406-7173
Mailing Address - Street 1:450 STATE ROAD 13 STE 106
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-3863
Mailing Address - Country:US
Mailing Address - Phone:440-941-5325
Mailing Address - Fax:855-811-3450
Practice Address - Street 1:450 STATE ROAD 13 STE 106
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-3863
Practice Address - Country:US
Practice Address - Phone:440-941-5325
Practice Address - Fax:855-811-3450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-28
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 208600000X
FLPA9106954363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty