Healthcare Provider Details

I. General information

NPI: 1932391463
Provider Name (Legal Business Name): TRINITY FAMILY PHYSICIANS PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 CYPRESS BROOK DR SUITE 101
TRINITY FL
34655-4414
US

IV. Provider business mailing address

1817 CYPRESS BROOK DR SUITE 101
TRINITY FL
34655-4414
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-8377
  • Fax: 727-834-8371
Mailing address:
  • Phone: 727-834-8377
  • Fax: 727-834-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AMIR SHIRMOHAMMAD
Title or Position: PHYSICIAN
Credential: MD
Phone: 813-494-5272