| NPI | 1023574696 |
|---|---|
| Doing Business As | TRIDENT PRIMARY & PREVENTATIVE CARE |
| Entity Type | Organization |
| Authorized Contact | JOHN POULOS Owner 954-451-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-08-26 |