Organization · NPI-2

Flowood River Oaks Hma Medical Group, LLC

Internal Medicine · Flowood, MS

NPI number1619244589

StatusActive

Last updated in NPPESNov 27, 2012

Details

NPI: 1619244589
Entity type: Organization (NPI-2)
Legal business name: Flowood River Oaks Hma Medical Group, LLC
Organization subpart: Yes
Enumeration date: Nov 21, 2011
Last updated: Nov 27, 2012

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
133V00000X	Dietitian, Registered	–	–
363L00000X	Nurse Practitioner	–	–

Other names

Transformation At River Oaks (Doing Business As)

Practice location

2550 Flowood Dr
Suite 302
Flowood, MS 39232-9303

Phone 601-936-1170 · Fax 601-936-1331

Mailing address

5811 Pelican Bay Blvd
Suite 500
Naples, FL 34108-2733

Phone 239-598-3131 · Fax 239-592-0438

Authorized official

Michael L Gingras
Vice President
2395983131

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