# ALLERGY AND IMMUNOLOGY CARE CENTER OF SOUTH FLORIDA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013444603
- **Authorized official:** VIVIAN HERNANDEZ-TRUJILLO MD (SOLE MEMBER)
- **Authorized official phone:** (786) 646-9280

## Contact information

- **Practice address:** 16371 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
- **Practice address phone:** (786) 646-9280
- **Mailing address:** 16371 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
- **Mailing address phone:** (786) 646-9280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | FL | — |
| 2080P0201X | Pediatric Allergy/Immunology Physician | — | FL | Yes |

## Other

- **Enumeration date:** 05/15/2017
- **Last updated:** 07/21/2022