MEDICARE: TRIUNITY WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1609738798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUNITY WELLNESS LLC

Provider Business Mailing Address
First Line	:	5002 WAYDALE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2733
Country	:	US
Telephone Number	:	813-908-0675
Fax Number	:	813-558-5971

Provider Business Practice Location Address
First Line	:	3971 MORAN RD STE 102
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4631
Country	:	US
Telephone Number	:	813-908-0675
Fax Number	:	813-558-5971

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. SAMER MIKHAIL
Credential	:	DO
Telephone Number	:	813-528-6462

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	11/26/2025

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