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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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