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General NPI Number Information
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NPI Number | 1578830840
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Entity Type | Organization
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Legal Business Name | DAVID M TRUEBA MDPA
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 11760 SW 83RD CT
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City | MIAMI
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State | FL
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Zip | 33156-5127
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Country | US
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Telephone | 786-493-4525
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Fax |
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Provider Business Mailing Address
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Address Line | 11760 SW 83RD CT
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City | MIAMI
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State | FL
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Zip | 33156-5127
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Country | US
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Telephone | 786-493-4525
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID M TRUEBA
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Credential | M.D.
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Telephone | 786-493-4525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME90860
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License Number State | FL
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