Healthcare Provider Details

I. General information

NPI: 1407952633
Provider Name (Legal Business Name): MIGUEL ANIBAL TRUJILLO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 NW 7TH ST
MIAMI FL
33126-3129
US

IV. Provider business mailing address

3618 PALMETTO AVE
CORAL GABLES FL
33133-6221
US

V. Phone/Fax

Practice location:
  • Phone: 305-264-1000
  • Fax:
Mailing address:
  • Phone: 305-444-5495
  • Fax: 305-444-5195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS7828
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: