MEDICARE: ALEJANDRO TRUJILLO SR. 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	208D00000X	General Practice Physician	ACN1348	FL

General Provider Information

NPI Number	:	1528553856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO TRUJILLO SR. MD

Provider Business Mailing Address
First Line	:	PO BOX 25487
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34277-2487
Country	:	US
Telephone Number	:	941-216-0072
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 SE 16TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3818
Country	:	US
Telephone Number	:	239-673-6516
Fax Number	:	239-673-6536

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

Provider Enumeration Date	:	06/28/2018
Last Update Date	:	10/05/2023

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