Trident Anti Aging, LLC
NPI #1023574696 in Fort Lauderdale, Florida
Provider Information
- NPI Number
- 1023574696
- Entity Type
- Organization
- Organization Name
- Trident Anti Aging, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Feb 19, 2019
- Last Updated
- Aug 26, 2019
Practice Location
- Address
- 800 E BROWARD BLVD STE 400
- City
- Fort Lauderdale
- State
- Florida
- ZIP Code
- 33301-2033
- Phone
- (954) 451-5454
Authorized Official
- Name
- JOHN POULOS
- Title
- OWNER
- Phone
- (954) 451-5454
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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