Provider Demographics
NPI:1366426561
Name:TRIGO, GISELA (MD)
Entity type:Individual
Prefix:
First Name:GISELA
Middle Name:
Last Name:TRIGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4716
Mailing Address - Country:US
Mailing Address - Phone:352-726-8353
Mailing Address - Fax:352-726-5038
Practice Address - Street 1:308 W HIGHLAND BLVD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4716
Practice Address - Country:US
Practice Address - Phone:352-726-8353
Practice Address - Fax:352-726-5038
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60456207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4877331OtherCIGNA
FL77940OtherBCBS OF FL GROUP ID
FLME0060456OtherSTATE LICENSE NUMBER
FL373867100Medicaid
FL23546OtherBCBS OF FL
FL11319386OtherCAQH
FL060025265OtherMEDICARE RR
FL77940OtherMEDICARE GROUP ID
FL269859500OtherMEDICAID GROUP
FLCF1416OtherMEDICARE RR GROUP
FLCF1416OtherMEDICARE RR GROUP
FL373867100Medicaid