Provider Demographics
NPI:1538111455
Name:MOSS, TRINETTE D (MD)
Entity Type:Individual
Prefix:DR
First Name:TRINETTE
Middle Name:D
Last Name:MOSS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1831 N BELCHER RD
Mailing Address - Street 2:SUITE C3
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1449
Mailing Address - Country:US
Mailing Address - Phone:727-754-4959
Mailing Address - Fax:727-754-5910
Practice Address - Street 1:1831 N BELCHER RD
Practice Address - Street 2:SUITE C3
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1449
Practice Address - Country:US
Practice Address - Phone:727-754-4959
Practice Address - Fax:727-754-5910
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2015-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME79327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080193769OtherRAILROAD MEDICARE
FL266047400Medicaid
H51116Medicare UPIN
FL266047400Medicaid