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Organization

TRINITY FAMILY AND SPORTS MEDICINE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSE D TIPPETT MD (OWNER)
(727) 376-3547
Entity
Organization

Contact information

Practice address
1807 SHORT BRANCH DR, #102, TRINITY, FL 34655-4415
(727) 376-3547
(866) 439-9035
Mailing address
1807 SHORT BRANCH DRIVE, #102, TRINITY, FL 34655
(727) 376-3547
(866) 439-9035

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME93868
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279176500
FL
Enumeration date
06/22/2007
Last updated
07/12/2016
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