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Organization
ALLERGY AND IMMUNOLOGY CARE CENTER OF SOUTH FLORIDA, LLC
Active
Organization
ALLERGY AND IMMUNOLOGY CARE CENTER OF SOUTH FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN HERNANDEZ-TRUJILLO MD (SOLE MEMBER)
(786) 646-9280
Entity
Organization
Contact information
Practice address
16371 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
(786) 646-9280
Mailing address
16371 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
(786) 646-9280
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
FL
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
—
FL
Other
Enumeration date
05/15/2017
Last updated
07/21/2022
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