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General NPI Number Information
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NPI Number | 1669063236
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Entity Type | Organization
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Legal Business Name | TRINITY COMMUNITY HEALTH CENTER, LLC.
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 3156 S UNIVERSITY DR
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City | MIRAMAR
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State | FL
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Zip | 33025-3001
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Country | US
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Telephone | 786-234-2519
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Fax | 786-590-1903
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Provider Business Mailing Address
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Address Line | 3156 S UNIVERSITY DR
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City | MIRAMAR
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State | FL
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Zip | 33025-3001
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Country | US
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Telephone | 754-217-3929
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Fax | 754-217-3931
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Authorized Official
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Title or Position | ADVANCED PRACTICE REGISTERED NURSE
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Name | JEAN CLAUDE MEDINA
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Credential | AP-APRN
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Telephone | 754-217-3929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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