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General NPI Number Information
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NPI Number | 1598782401
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Entity Type | Organization
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Legal Business Name | TRINITY FAMILY MEDICAL CENTER, PA
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1850 PREVATT ST
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City | EUSTIS
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State | FL
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Zip | 32726-6123
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Country | US
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Telephone | 352-253-2511
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Fax | 352-253-2522
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | EUSTIS
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State | FL
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Zip | 32727-0490
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Country | US
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Telephone | 352-253-2511
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Fax | 352-253-2522
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN E YOUNG
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Credential | DO
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Telephone | 352-253-2511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 059170
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License Number State | FL
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