Organization
TRIDENT MEDICAL MANAGEMENT, INC.
Active
Other names
Trident Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AKINWUMI GAMMAL ALADESAWE M.D. (MEDICAL DIRECTOR)
(727) 842-6900
Entity
Organization
Contact information
Practice address
6131 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-2527
(727) 842-6900
(727) 842-6902
Mailing address
6131 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-2527
(727) 842-6900
(727) 842-6902
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
ME112766
FL
261QP3300X
Pain Clinic/Center
Primary
ME112766
FL
Other
Enumeration date
10/29/2010
Last updated
10/11/2012
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