Provider Demographics
NPI:1316817901
Name:SULBARAN, MARIA TRINIDAD (RDMS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TRINIDAD
Last Name:SULBARAN
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5423 W MOUNT CONNESS PL
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-1412
Mailing Address - Country:US
Mailing Address - Phone:801-403-1646
Mailing Address - Fax:
Practice Address - Street 1:5423 W MOUNT CONNESS PL
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-1412
Practice Address - Country:US
Practice Address - Phone:801-403-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-08
Last Update Date:2025-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3071702471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography