Provider Demographics
NPI:1649769837
Name:TRUEBA, MICHAEL A (PA-C)
Entity Type:Individual
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First Name:MICHAEL
Middle Name:A
Last Name:TRUEBA
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:38135 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:17417 BRIDGE HILL CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3467
Practice Address - Country:US
Practice Address - Phone:813-972-7900
Practice Address - Fax:813-355-5035
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2023-10-19
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Provider Licenses
StateLicense IDTaxonomies
FLPA9111237363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical