Healthcare Provider Details

I. General information

NPI: 1508721903
Provider Name (Legal Business Name): PAMELA JO TROUT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5107 DAHLIA ST N
PINELLAS PARK FL
33782-3529
US

IV. Provider business mailing address

5107 DAHLIA ST N
PINELLAS PARK FL
33782-3529
US

V. Phone/Fax

Practice location:
  • Phone: 402-670-6623
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: