NPI 1023574696

Trident Anti Aging, LLC

Organisation Family Medicine Physician Fort Lauderdale, FL

Practice location

Address: 800 E Broward Blvd STE 400, Fort Lauderdale, FL 33301-2033
Phone: (954) 451-5454

Authorised official

Name: John Poulos
Title: Owner
Phone: (954) 451-5454

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Florida →

Registry record

NPI: 1023574696
Entity type: Organization
NPI issued: 19 Feb 2019
Record last updated: 26 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.