Organization
TREJO THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS TREJO (PRESIDENT)
(305) 228-1622
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD, SUITE 1-G2, MIAMI, FL 33172-7018
(305) 228-1622
(305) 228-1611
Mailing address
175 FONTAINEBLEAU BLVD, SUITE 1-G2, MIAMI, FL 33172-7018
(305) 228-1622
(305) 228-1611
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC9440
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FILE 10005
AHCA HCC UNIT
FL
Enumeration date
05/28/2012
Last updated
05/28/2012
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