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General NPI Number Information
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NPI Number | 1588206809
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Entity Type | Individual
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Provider Name | VICTORIA TRUJILLO
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Gender | Female
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Dates
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Enumeration Date | 10/09/2019
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 3670 N 54TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2340
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Country | US
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Telephone | 239-223-2296
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Fax |
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Provider Business Mailing Address
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Address Line | 841 SW 47TH TER APT 104
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City | CAPE CORAL
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State | FL
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Zip | 33914-4340
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Country | US
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Telephone | 239-223-2296
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 20373
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License Number State | FL
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