Provider Demographics
NPI:1609643253
Name:TRIDENTE, LUISANA MARGARITA
Entity Type:Individual
Prefix:
First Name:LUISANA
Middle Name:MARGARITA
Last Name:TRIDENTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7315 BROMPTON ST APT 138B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2114
Mailing Address - Country:US
Mailing Address - Phone:786-609-5142
Mailing Address - Fax:
Practice Address - Street 1:7315 BROMPTON ST APT 138B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-2114
Practice Address - Country:US
Practice Address - Phone:786-609-5142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator