Healthcare Provider Details

I. General information

NPI: 1578040093
Provider Name (Legal Business Name): BRIAN JOSE VILLAFUERTE TRISOLINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 400W
MIAMI FL
33176-2132
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-3876
  • Fax: 786-533-9989
Mailing address:
  • Phone: 786-662-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME162188
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME162188
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: