MEDICARE: EDUARDO TREJO M.D.

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	208M00000X	Hospitalist Physician	ME140322	FL
2	207R00000X	Internal Medicine Physician	ME140322	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932554631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDUARDO TREJO M.D.

Provider Business Mailing Address
First Line	:	3304 SE LAKE WEIR AVE STE 3
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-8602
Country	:	US
Telephone Number	:	352-272-4730
Fax Number	:

Provider Business Practice Location Address
First Line	:	3304 SE LAKE WEIR AVE STE 3
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-8602
Country	:	US
Telephone Number	:	352-789-3325
Fax Number	:

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

Provider Enumeration Date	:	04/30/2016
Last Update Date	:	06/21/2019

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