Trident Primary & Preventative Care | |
800 E Broward Blvd Ste 400 Fort Lauderdale FL 33301-2033 | |
(954) 451-5454 | |
Not Available |
Full Name | Trident Primary & Preventative Care |
---|---|
Speciality | Family Medicine |
Location | 800 E Broward Blvd Ste 400, Fort Lauderdale, Florida |
Authorized Official Name and Position | John Poulos (OWNER) |
Authorized Official Contact | 9544515454 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Trident Primary & Preventative Care 800 E Broward Blvd Ste 400 Fort Lauderdale FL 33301-2033 Ph: (954) 451-5454 | Trident Primary & Preventative Care 800 E Broward Blvd Ste 400 Fort Lauderdale FL 33301-2033 Ph: (954) 451-5454 |
NPI Number | 1023574696 |
---|---|
Provider Enumeration Date | 02/19/2019 |
Last Update Date | 08/26/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023574696 | NPI | - | NPPES |
1750407086 | Medicaid | FL | |
1750716387 | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
News Archive
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