MEDICARE: JENNIFER JOY T TRINIDAD DPT, CNS

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	225100000X	Physical Therapist	PT23826	FL

General Provider Information

NPI Number	:	1790652667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JOY T TRINIDAD DPT, CNS

Provider Business Mailing Address
First Line	:	5840 26TH ST W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-3522
Country	:	US
Telephone Number	:	941-752-5184
Fax Number	:

Provider Business Practice Location Address
First Line	:	5840 26TH ST W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-3522
Country	:	US
Telephone Number	:	941-752-5184
Fax Number	:

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

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	10/23/2025

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