MEDICARE: TRINITY HEALTH CARE SERVICES, LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1770652844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY HEALTH CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	6151 MIRAMAR PKWY
Second Line	:	SUITE 101
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3970
Country	:	US
Telephone Number	:	954-986-1754
Fax Number	:	954-986-1757

Provider Business Practice Location Address
First Line	:	6151 MIRAMAR PKWY
Second Line	:	SUITE 101
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3970
Country	:	US
Telephone Number	:	954-986-1754
Fax Number	:	954-986-1757

Authorized Official
Title or Position	:	CEO ADMINISTRATOR
Name	:	DR. GABRIEL T SMITH
Credential	:	MD
Telephone Number	:	954-986-1754

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	11/06/2017

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