Provider Demographics
NPI:1811035629
Name:PELAYO, TRINITY
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:
Last Name:PELAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 101ST AVE E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2009
Mailing Address - Country:US
Mailing Address - Phone:941-744-6279
Mailing Address - Fax:317-708-6496
Practice Address - Street 1:630 N MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4423
Practice Address - Country:US
Practice Address - Phone:407-539-2488
Practice Address - Fax:407-539-2408
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9757224Z00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant