OrganizationActive
Trident Anti Aging, LLC
NPI 1023574696 · Family Medicine Physician · Fort Lauderdale, FL
Provider details
- NPI number
- 1023574696
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Poulos, Owner(954) 451-5454
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
800 E Broward Blvd Ste 400
Fort Lauderdale, FL 33301-2033
Phone: (954) 451-5454
Street-level locationGet directions
Mailing address
800 E Broward Blvd Ste 400
Fort Lauderdale, FL 33301-2033
Other names (DBA / former)
- Doing business as
- Trident Primary & Preventative Care
- Doing business as
- Trident Primary & Preventative Care
Registry dates
- Enumerated
- 2019-02-19
- Last updated
- 2019-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.