OrganizationActive
Trinity Health South PLLC
NPI 1780126664 · Internal Medicine Physician · St Augustine, FL
Provider details
- NPI number
- 1780126664
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Wendy Lu, Credentialing Coordinator(904) 221-2535
- License
- ME104865 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
475 W Town Pl
Suite 105
St Augustine, FL 32092-3648
Phone: (904) 806-4579
Fax: (904) 863-5566
Street-level locationGet directions
Mailing address
110 Calle Norte
St Augustine, FL 32092
Registry dates
- Enumerated
- 2016-11-09
- Last updated
- 2016-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.