MEDICARE: YANETH TRUJILLO MD.PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	080274	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	2084P0800X	Psychiatry Physician
4	261QP2300X	Primary Care Clinic/Center	ME99221	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093951196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YANETH TRUJILLO MD.PA

Provider Business Mailing Address
First Line	:	1290 WESTON RD STE 203
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-1909
Country	:	US
Telephone Number	:	954-436-8036
Fax Number	:

Provider Business Practice Location Address
First Line	:	1290 WESTON RD STE 203
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-1909
Country	:	US
Telephone Number	:	954-436-8036
Fax Number	:	954-949-9180

Authorized Official
Title or Position	:	FAMILY PHYSICIAN
Name	:	DR. YANETH TRUJILLO
Credential	:	MD
Telephone Number	:	954-675-9671

Provider Enumeration Date	:	12/20/2008
Last Update Date	:	11/12/2025

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