Provider Demographics
NPI:1427275668
Name:TRIANA, SERGIO MAURICO (DC,MS)
Entity type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:MAURICO
Last Name:TRIANA
Suffix:
Gender:M
Credentials:DC,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3309
Mailing Address - Country:US
Mailing Address - Phone:954-973-1913
Mailing Address - Fax:954-973-7426
Practice Address - Street 1:157 S POMPANO PKWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3003
Practice Address - Country:US
Practice Address - Phone:954-973-1913
Practice Address - Fax:954-973-7426
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL76940OtherFLBCBS