Healthcare Provider Details

I. General information

NPI: 1881501856
Provider Name (Legal Business Name): ERVING MURILLO JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

2295 NW 155TH ST
OPA LOCKA FL
33054-2748
US

V. Phone/Fax

Practice location:
  • Phone: 800-541-6682
  • Fax:
Mailing address:
  • Phone: 786-317-6269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberM244059632000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: