MEDICARE: DR. YANETH TRUJILLO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME99221	FL

General Provider Information

NPI Number	:	1184753246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YANETH TRUJILLO MD

Provider Business Mailing Address
First Line	:	1290 WESTON RD STE 203
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-1909
Country	:	US
Telephone Number	:	954-436-8036
Fax Number	:	954-217-4006

Provider Business Practice Location Address
First Line	:	1290 WESTON RD STE 203
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-1909
Country	:	US
Telephone Number	:	954-436-8036
Fax Number	:	954-217-4006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	04/26/2024

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