Provider Demographics
NPI:1093544967
Name:TRUJILLO GALVEZ, JUAN JOSE (APRN)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:JOSE
Last Name:TRUJILLO GALVEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5532
Mailing Address - Country:US
Mailing Address - Phone:305-929-6150
Mailing Address - Fax:
Practice Address - Street 1:1251 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5532
Practice Address - Country:US
Practice Address - Phone:305-929-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily