Provider Demographics
NPI:1285203356
Name:BARRICK, TRENTON D (MT-BC)
Entity type:Individual
Prefix:MR
First Name:TRENTON
Middle Name:D
Last Name:BARRICK
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 LYONS RD APT 24102
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33063-6730
Mailing Address - Country:US
Mailing Address - Phone:754-400-0585
Mailing Address - Fax:954-953-2833
Practice Address - Street 1:841 LYONS RD APT 24102
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063-6730
Practice Address - Country:US
Practice Address - Phone:754-400-0585
Practice Address - Fax:954-953-2833
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty