Organization · Type 2 NPI

Trident Anti Aging, LLC

Family Medicine Physician · Fort Lauderdale, FL

NPI number 1023574696 Active

Practice location

800 E Broward Blvd Ste 400
Fort Lauderdale, FL 33301-2033

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

Other family medicine physician providers in Fort Lauderdale

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NPI record

NPI: 1023574696
Entity type: Organization (Type 2)
Issued: Feb 19, 2019
Last updated: Aug 26, 2019
Status: Active

Other names

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Trident Primary & Preventative Care · doing business as
Trident Primary & Preventative Care · doing business as

Authorized official

John Poulos
Owner
(954) 451-5454

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1023574696

Trident Anti Aging, LLC's National Provider Identifier is 1023574696, issued on Feb 19, 2019. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Fort Lauderdale, FL. The record was last updated on Aug 26, 2019.