Healthcare Provider Details

I. General information

NPI: 1285362194
Provider Name (Legal Business Name): JORGE TRAPAGA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 NW 49TH ST STE 150
FORT LAUDERDALE FL
33309-3763
US

IV. Provider business mailing address

4987 SW 166TH AVE
MIRAMAR FL
33027-4903
US

V. Phone/Fax

Practice location:
  • Phone: 954-768-6232
  • Fax: 954-768-6233
Mailing address:
  • Phone: 954-534-6429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF08210558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: