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General NPI Number Information
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NPI Number | 1356686166
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Entity Type | Organization
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Legal Business Name | TRINITY PACIFIC 5, LLC
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 28051 US HIGHWAY 19 N STE 107
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City | CLEARWATER
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State | FL
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Zip | 33761-2642
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Country | US
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Telephone | 727-295-9711
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Fax | 727-815-8040
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Provider Business Mailing Address
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Address Line | 740 4TH ST N # 240
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-2322
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Country | US
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Telephone | 727-295-9711
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Fax | 727-815-8040
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Authorized Official
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Title or Position | COO / PARTNER / ADMINSTRATOR
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Name | DAVID MCELWEE
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Credential |
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Telephone | 727-295-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299992887
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License Number State | FL
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