MEDICARE: TRUJILLO MULTI-HEALTHCARE LLC

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	163WD0400X	Diabetes Educator Registered Nurse
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1851114615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUJILLO MULTI-HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	5561 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-6008
Country	:	US
Telephone Number	:	918-584-8947
Fax Number	:	918-584-8973

Provider Business Practice Location Address
First Line	:	5561 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-6008
Country	:	US
Telephone Number	:	918-584-8947
Fax Number	:	918-584-8973

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	FRANCISCA TRUJILLO
Credential	:	DNP, FNP-BC, BC-ADM
Telephone Number	:	918-584-8947

Provider Enumeration Date	:	10/31/2024
Last Update Date	:	10/31/2024

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