Healthcare Provider Details

I. General information

NPI: 1750103164
Provider Name (Legal Business Name): TROPHOS STAFFING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 MATADOR DR SE
ALBUQUERQUE NM
87123-4222
US

IV. Provider business mailing address

1011 MATADOR DR SE
ALBUQUERQUE NM
87123-4222
US

V. Phone/Fax

Practice location:
  • Phone: 505-975-1304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARIO MIGLIORE
Title or Position: PRESIDENT/OWNER
Credential: NURSE PRACTITIONER
Phone: 505-975-1304