Provider Demographics
NPI:1700818515
Name:TRENT, JENNIFER T (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:T
Last Name:TRENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5741BEE RIDGE ROAD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:941-379-6647
Mailing Address - Fax:941-379-0611
Practice Address - Street 1:5741 BEE RIDGE RD
Practice Address - Street 2:SUITE 450
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5064
Practice Address - Country:US
Practice Address - Phone:941-379-6647
Practice Address - Fax:941-379-0611
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 92484207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29464ZMedicare ID - Type Unspecified
FLI40224Medicare UPIN