Provider Demographics
NPI:1144986605
Name:TRUJIJO, MIGUEL-ANTONIO
Entity type:Individual
Prefix:
First Name:MIGUEL-ANTONIO
Middle Name:
Last Name:TRUJIJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3383 NW 7TH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4163
Mailing Address - Country:US
Mailing Address - Phone:786-580-3923
Mailing Address - Fax:786-580-3984
Practice Address - Street 1:3383 NW 7TH ST STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4163
Practice Address - Country:US
Practice Address - Phone:786-580-3923
Practice Address - Fax:786-580-3984
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50169207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)