Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | UO4620 | FL |
NPI | 1003299314 |
---|---|
Provider Name | Dr. Julian Andrew Trivino |
First Address | Orlando, FL 32822-8224 |
Second Address | Orlando, FL 32822-8224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2015 |
Last Update Date | 06/07/2015 |