Provider Demographics
NPI:1235526153
Name:TRINIDAD PROFESSIONAL SERVICES INC
Entity Type:Organization
Organization Name:TRINIDAD PROFESSIONAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-263-7459
Mailing Address - Street 1:PO BOX 3264
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736
Mailing Address - Country:US
Mailing Address - Phone:787-263-7459
Mailing Address - Fax:
Practice Address - Street 1:D16 CALLE 2
Practice Address - Street 2:URB LA PLANICIE
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-263-7459
Practice Address - Fax:787-535-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10263208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty