Healthcare Provider Details

I. General information

NPI: 1043128812
Provider Name (Legal Business Name): TRUSTED TO CARE MEDICAL & WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 13TH ST
SAINT CLOUD FL
34769-4205
US

IV. Provider business mailing address

2021 13TH ST
SAINT CLOUD FL
34769-4205
US

V. Phone/Fax

Practice location:
  • Phone: 787-948-0768
  • Fax:
Mailing address:
  • Phone: 787-948-0768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: NIVIA ELIS RODRIGUEZ VILLANUEVA
Title or Position: OWNER
Credential: MD
Phone: 787-948-0768