Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME0039928 | FL |
N | 207QA0401X | Family Doctor - Addiction Medicine | ME0039928 | FL |
NPI | 1306806187 |
---|---|
Provider Name | Craig Anthony Trigueiro |
First Address | Bradenton, FL 34203-5827 |
Second Address | Bradenton, FL 34203-5867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 02/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372787400 | (05) | FL |
D84415 | (02) | FL |