Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Trident Sports Medicine and Rehabilitation Inc

Organization Sports Medicine (Family Medicine) Physician · NPI 1811766637

Trident Sports Medicine and Rehabilitation Inc provides Sports Medicine (Family Medicine) Physician services in Ormond Beach, Florida. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

873 Hull Rd Unit 12
Ormond Beach, FL 32174-0738
Phone: (386) 267-2965
Fax: (386) 603-6007
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X
Hearing and Speech Clinic/Center Taxonomy 261QH0700X
Physical Therapy Clinic/Center Taxonomy 261QP2000X

Record details

NPI number1811766637
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Lynch — President · (570) 762-3953
NPI enumeratedDecember 20, 2023
Last updated in NPPESMay 8, 2024
Certification dateMay 8, 2024
Mailing address873 Hull Rd Unit 12, Ormond Beach, FL 32174-0738

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