Provider Demographics
NPI:1558681395
Name:TRINIDAD ORTHOPAEDICS AND SPORTSMEDICINE INC
Entity type:Organization
Organization Name:TRINIDAD ORTHOPAEDICS AND SPORTSMEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-351-0980
Mailing Address - Street 1:415 GREENWELL AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5302
Mailing Address - Country:US
Mailing Address - Phone:513-557-3960
Mailing Address - Fax:513-557-3506
Practice Address - Street 1:1729 KINNEYS LANE
Practice Address - Street 2:SUITE-102
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3166
Practice Address - Country:US
Practice Address - Phone:740-351-0980
Practice Address - Fax:740-351-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3052940Medicaid
OH4038602Medicare PIN