| Trinity Family Clinic | |
|
506 Nw 4th Street Jasper FL 32052-6603 | |
| (386) 792-7247 | |
| (386) 792-7257 |
| Full Name | Trinity Family Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 506 Nw 4th Street, Jasper, Florida |
| Authorized Official Name and Position | Robert Krasnow (OWNER/PRESIDENT) |
| Authorized Official Contact | 3867927200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Family Clinic 506 Nw 4th Street Jasper FL 32052-6603 Ph: (386) 792-7247 | Trinity Family Clinic 506 Nw 4th Street Jasper FL 32052-6603 Ph: (386) 792-7247 |
| NPI Number | 1205912326 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 12/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205912326 | NPI | - | NPPES |
| 660106500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 80014936 (Florida) | Primary |
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