Provider Demographics
NPI:1811539984
Name:TRINIDAD, ANNIS AMELIN (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNIS
Middle Name:AMELIN
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:ANNIS
Other - Middle Name:
Other - Last Name:TRINIDAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2371 BALLARD AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32833-3854
Mailing Address - Country:US
Mailing Address - Phone:646-223-0260
Mailing Address - Fax:
Practice Address - Street 1:210 LOOKOUT PL
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4491
Practice Address - Country:US
Practice Address - Phone:407-215-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily