Provider Demographics
NPI:1700505625
Name:SALTAFORMAGGIO, TRINITY (MS, LAT, ATC, NREMT)
Entity type:Individual
Prefix:
First Name:TRINITY
Middle Name:
Last Name:SALTAFORMAGGIO
Suffix:
Gender:F
Credentials:MS, LAT, ATC, NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3148 DICK WILSON BLVD APT 617
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-5151
Mailing Address - Country:US
Mailing Address - Phone:504-400-3185
Mailing Address - Fax:
Practice Address - Street 1:1104 SPIRIT WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306-0001
Practice Address - Country:US
Practice Address - Phone:504-400-3185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146N00000X
FLAL71832255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic