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General NPI Number Information
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NPI Number | 1487962635
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Entity Type | Individual
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Provider Name | LIZ A TRUJILLO
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Gender | Female
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 03/12/2022
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Provider Practice Location Address
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Address Line | 1240 PINE SAGE CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-7062
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Country | US
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Telephone | 561-425-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 PINE SAGE CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-7062
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Country | US
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Telephone | 561-425-2213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | FL
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