MEDICARE: TRINA JOHNSON PETTIFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364S00000X	Clinical Nurse Specialist	9244404	FL

General Provider Information

NPI Number	:	1003786070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINA JOHNSON PETTIFORD

Provider Business Mailing Address
First Line	:	8642 NW 55TH PL
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2808
Country	:	US
Telephone Number	:	954-638-7096
Fax Number	:

Provider Business Practice Location Address
First Line	:	8642 NW 55TH PL
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2808
Country	:	US
Telephone Number	:	954-638-7096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	11/06/2025

Similar Medicare Providers

1134507338 — FLORENCE MORRISON
Practice Location Address:

9881 NW 37TH ST
CORAL SPRINGS, FL
33065-2808

Practice Phone: 954-603-7926
Practice Fax:

1053078436 — TAMARA L ANTOINE APRN
Practice Location Address:

9841 NW 37TH ST
CORAL SPRINGS, FL
33065-2808

Practice Phone: 954-851-5456
Practice Fax:

1982351904 — MIRANIS RODRIGUEZ CORDOVA
Practice Location Address:

717 SE 8TH ST APT 4
CAPE CORAL, FL
33990-2808

Practice Phone: 832-942-4001
Practice Fax:

1700566197 — DENIA MENDEZ HERNANDEZ
Practice Location Address:

310 NE 24TH AVE
CAPE CORAL, FL
33909-2808

Practice Phone: 786-414-0539
Practice Fax:

1285628750 — FRANCIS R MCCULLY JR. M.D.
Practice Location Address:

1468 HILLTOP RD
CHESTER SPRINGS, PA
19425-2808

Practice Phone: 865-766-6870
Practice Fax:

1174683312 — LEGACY HOSPICE, L.L.C
Practice Location Address:

2808 HOT SPRINGS BOULEVARD
LAS VEGAS, NM
87701-0670

Practice Phone: 505-454-8099
Practice Fax: 505-454-8094

Directions to “ TRINA JOHNSON PETTIFORD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.