Trinity Health South Pllc

NPI #1780126664 in St Augustine, Florida

Provider Information

NPI Number: 1780126664
Entity Type: Organization
Organization Name: Trinity Health South Pllc
Primary Specialty: Internal Medicine
Enumeration Date: Nov 9, 2016
Last Updated: Nov 9, 2016

Practice Location

Address: 475 W TOWN PL
Address 2: SUITE 105
City: St Augustine
State: Florida
ZIP Code: 32092-3648
Phone: (904) 806-4579

Authorized Official

Name: WENDY C LU
Title: CREDENTIALING COORDINATOR
Phone: (904) 221-2535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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