Healthcare Provider Details

I. General information

NPI: 1891006045
Provider Name (Legal Business Name): TRINA MARIE HUTTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRINA MARIE ENTELISANO ARNP

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 100108 ROOM M-602
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

425 W TANNER PL
CITRUS SPRINGS FL
34434-6173
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5670
  • Fax: 352-273-5683
Mailing address:
  • Phone: 352-260-2366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP9221896
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number9221896
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: