Provider Demographics
NPI:1558435768
Name:TRIANA, ANGEL F (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:F
Last Name:TRIANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 NW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1610
Mailing Address - Country:US
Mailing Address - Phone:305-243-6704
Mailing Address - Fax:305-243-3503
Practice Address - Street 1:1295 NW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1610
Practice Address - Country:US
Practice Address - Phone:305-243-6704
Practice Address - Fax:305-243-3503
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107439207N00000X
MDD37292207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
479L397CMedicare PIN
E40552Medicare UPIN