Basic Information
| Provider Information | |||||||||
| NPI: | 1013289917 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TITAN HOSPITALIST GROUP LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4311 SALISBURY RD | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322166123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043324316 | ||||||||
| FaxNumber: | 9043324339 | ||||||||
| Practice Location | |||||||||
| Address1: | 2626 CAPITAL MEDICAL BLVD | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323084402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043324316 | ||||||||
| FaxNumber: | 9043324339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2012 | ||||||||
| LastUpdateDate: | 02/08/2012 | ||||||||
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| AuthorizedOfficialLastName: | GYARMATHY | ||||||||
| AuthorizedOfficialFirstName: | RAYMOND | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9043324316 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | FL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.