Provider Demographics
NPI:1033356654
Name:TRINITY PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:TRINITY PEDIATRICS, P.C.
Other - Org Name:FERDINAND ESPELETA MD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPELETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-575-1080
Mailing Address - Street 1:1525 HUNT CLUB BLVD
Mailing Address - Street 2:SUITE 600-A
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6070
Mailing Address - Country:US
Mailing Address - Phone:615-575-1080
Mailing Address - Fax:615-575-1084
Practice Address - Street 1:1525 HUNT CLUB BLVD
Practice Address - Street 2:SUITE 600-A
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6070
Practice Address - Country:US
Practice Address - Phone:615-575-1080
Practice Address - Fax:615-575-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000034095208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510219Medicaid
TN1510210Medicaid
TN1510219Medicaid