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General NPI Number Information
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NPI Number | 1689144933
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Entity Type | Individual
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Provider Name | MIGUEL RODRIGUEZ TRIANA
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Gender | Male
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 180 SW 84TH AVE
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City | PLANTATION
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State | FL
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Zip | 33324-2731
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Country | US
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Telephone | 954-377-4970
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Fax |
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Provider Business Mailing Address
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Address Line | 1997 NE 15TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33305-3262
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Country | US
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Telephone | 239-572-5337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1770
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11000300
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License Number State | FL
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