Provider Demographics
NPI:1821605205
Name:TRINITY INTERNAL MEDICINE
Entity Type:Organization
Organization Name:TRINITY INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARMINEOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-324-0424
Mailing Address - Street 1:1301 S INTERNATIONAL PKWY STE 2021
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1411
Mailing Address - Country:US
Mailing Address - Phone:407-324-0424
Mailing Address - Fax:
Practice Address - Street 1:2500 W LAKE MARY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3501
Practice Address - Country:US
Practice Address - Phone:407-324-0424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty