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Individual

LUIS BERNARDO TRUJILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA 39379

Contact information

Practice address
2614 VINEDALE AVE, VALRICO, FL 33596-7383
(813) 719-0326
Mailing address
500 W MARTIN LUTHER KING BLVD, TAMPA, FL 33603-3402
(813) 307-0933

Taxonomy

Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
MA39379
FL

Other

Enumeration date
11/18/2009
Last updated
11/18/2009
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