Provider Demographics
NPI:1104240381
Name:TRINI-T MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:TRINI-T MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:813-215-2473
Mailing Address - Street 1:PO BOX 2236
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33595-2236
Mailing Address - Country:US
Mailing Address - Phone:813-215-2473
Mailing Address - Fax:888-284-2843
Practice Address - Street 1:3519 PINE TOP DR
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-7622
Practice Address - Country:US
Practice Address - Phone:813-215-2473
Practice Address - Fax:888-284-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3073902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty