Organization Name: | TRINI-T MEDICAL SERVICES LLC |
NPI Number: | 1104240381 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARLA BENJAMIN (NURSE PRACTITIONER) |
Mailing Address: | 3519 Pine Top Dr Valrico |
State: | FL US |
Postal Code: | 335947622 |
Phone Number: | 8132152473 |
Fax Number: | 8882842843 |
NPI Enumeration Date: | 02/10/2014 |
NPI Last Update Date: | 10/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP 3073902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |