Provider Demographics
NPI:1275806788
Name:TRELLES, GLORIA GIOVANNA (APRN)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:GIOVANNA
Last Name:TRELLES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10540 SW 93RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2608
Mailing Address - Country:US
Mailing Address - Phone:305-562-9467
Mailing Address - Fax:
Practice Address - Street 1:10540 SW 93RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2608
Practice Address - Country:US
Practice Address - Phone:305-562-9467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9276814163W00000X
FL11018786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse