Provider Demographics
NPI:1922556638
Name:TRN MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:TRN MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CAP, CMHP, CHT
Authorized Official - Phone:561-822-3620
Mailing Address - Street 1:1718 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-6643
Mailing Address - Country:US
Mailing Address - Phone:561-822-6320
Mailing Address - Fax:561-318-0836
Practice Address - Street 1:1718 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6643
Practice Address - Country:US
Practice Address - Phone:561-822-6320
Practice Address - Fax:561-318-0836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL RECOVERY NOW, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7281101YP2500X
FLARNP91662242163W00000X
FLOS9035207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty