Healthcare Provider Details

I. General information

NPI: 1093951196
Provider Name (Legal Business Name): YANETH TRUJILLO MD.PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2008
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 WESTON RD STE 203
WESTON FL
33326-1909
US

IV. Provider business mailing address

1290 WESTON RD STE 203
WESTON FL
33326-1909
US

V. Phone/Fax

Practice location:
  • Phone: 954-436-8036
  • Fax: 954-949-9180
Mailing address:
  • Phone: 954-436-8036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number080274
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME99221
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. YANETH TRUJILLO
Title or Position: FAMILY PHYSICIAN
Credential: MD
Phone: 954-675-9671