Healthcare Provider Details

I. General information

NPI: 1083318471
Provider Name (Legal Business Name): TROST FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N ORANGE AVENUE, SUITE 800 OFFICE #812
ORLANDO FL
32801
US

IV. Provider business mailing address

120 N FEDERAL HWY STE 206
LAKE WORTH FL
33460-3493
US

V. Phone/Fax

Practice location:
  • Phone: 407-470-1255
  • Fax:
Mailing address:
  • Phone: 407-470-1255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JARED TURNER
Title or Position: BILLING MANAGER
Credential:
Phone: 772-812-9652