Healthcare Provider Details

I. General information

NPI: 1891621777
Provider Name (Legal Business Name): TRIUNITY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LOUISIANA BLVD NE
ALBUQUERQUE NM
87108-2051
US

IV. Provider business mailing address

500 LOUISIANA BLVD NE
ALBUQUERQUE NM
87108-2051
US

V. Phone/Fax

Practice location:
  • Phone: 575-405-1390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SERGIO HUERTA
Title or Position: OWNER
Credential: DO
Phone: 575-405-1390