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Individual

HUMBERTO ENRIQUE TREJO BITTAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-1014
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
MD455497
PA
207ZP0101X
Anatomic Pathology Physician
Primary
ME153175
FL
207ZP0101X
Anatomic Pathology Physician
MT201181
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD455497
STATE MEDICAL LICENSE
PA
01
MT201181
STATE TRAINING MEDICAL LICENSE
PA
Enumeration date
04/02/2015
Last updated
01/06/2022
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