Active NPI
Trinity Community Health Center, LLC.
- Family Medicine Physician
- Miramar, FL
National Provider Identifier
1669063236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- TRINITY COMMUNITY HEALTH CENTER, LLC.
- Practice address
- 3156 S University Dr
Miramar, FL 33025-3001 - Phone
- (786) 234-2519
- Fax
- (786) 590-1903
- NPI assigned
- Jan 27, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jean Claude Medina, AP-APRN
- Title
- Advanced Practice Registered Nurse
- Phone
- (754) 217-3929
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Sports Medicine (Family Medicine) Physician | 207QS0010X | |||
| Community Health Clinic/Center | 261QC1500X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Family Nurse Practitioner | 363LF0000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | |||
| Primary Care Nurse Practitioner | 363LP2300X |
Addresses
Primary practice location
3156 S University Dr
Miramar, FL 33025-3001
Mailing address
3156 S University Dr
Miramar, FL 33025-3001
Phone (754) 217-3929
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235683822 | Other | FL | NPI |
| 1336371129 | Other | FL | DO (DOCTOR OF OSTEOPATHIC) |
| 1427400720 | Other | FL | NPI |
Other names 1
- TRINITY COMMUNITY HEALTH CENTER, LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2263442 | Trinity Community Health Center LLC | Certificate of waiver | Jun 27, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Primary Care Nurse Practitioner
- Miramar, FL
- NPI 1427400720
Psychiatric/Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683676800000",
"number": "1669063236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3156 S UNIVERSITY DR",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330253001",
"telephone_number": "754-217-3929",
"fax_number": "754-217-3931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3156 S UNIVERSITY DR",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330253001",
"telephone_number": "786-234-2519",
"fax_number": "786-590-1903"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRINITY COMMUNITY HEALTH CENTER, LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-27",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A",
"authorized_official_last_name": "MEDINA",
"authorized_official_first_name": "JEAN",
"authorized_official_middle_name": "CLAUDE",
"authorized_official_title_or_position": "ADVANCED PRACTICE REGISTERED NURSE",
"authorized_official_telephone_number": "754-217-3929",
"authorized_official_credential": "AP-APRN"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207QS0010X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1235683822",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DO (DOCTOR OF OSTEOPATHIC)",
"identifier": "1336371129",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1427400720",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "TRINITY COMMUNITY HEALTH CENTER, LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.