Provider Demographics
NPI:1740142223
Name:TRILLOS, DIANA CAROLINA (LDO)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:CAROLINA
Last Name:TRILLOS
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14462 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7225
Mailing Address - Country:US
Mailing Address - Phone:786-502-4336
Mailing Address - Fax:
Practice Address - Street 1:14462 SW 137TH CT
Practice Address - Street 2:OPTICAL WHEELS (MOBILE OPTICAL CLINIC)
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7225
Practice Address - Country:US
Practice Address - Phone:786-502-4336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO8195156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician