MEDICARE: LILIETT FRAGOSO TREJO

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	106S00000X	Behavior Technician	RBT20135303	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

General Provider Information

NPI Number	:	1164028700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIETT FRAGOSO TREJO

Provider Business Mailing Address
First Line	:	2230 SW 33RD TER
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-4336
Country	:	US
Telephone Number	:	954-638-1195
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 SW 33RD TER
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-4336
Country	:	US
Telephone Number	:	954-638-1195
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	12/11/2023

Similar Medicare Providers

1346244829 — SUSANNA F. BESHAI MD
Practice Location Address:

13685 DOCTORS WAY , SUITE 310
FORT MYERS, FL
33912-4336

Practice Phone: 239-275-6176
Practice Fax: 239-275-7245

1033119177 — LEAH LYNCH M.D.
Practice Location Address:

13685 DOCTORS WAY
FORT MYERS, FL
33912-4336

Practice Phone: 239-343-1953
Practice Fax: 239-343-4036

1790724144 — ELIZABETH ROCHE PA
Practice Location Address:

13685 DOCTORS WAY , SUITE 310
FORT MYERS, FL
33912-4336

Practice Phone: 239-343-1400
Practice Fax: 239-343-1430

1568535870 — GULF COAST MEDICAL PHARMACY INC
Practice Location Address:

13685 DOCTORS WAY , SUITE #150
FORT MYERS, FL
33912-4336

Practice Phone: 239-278-3969
Practice Fax: 239-278-0336

1528119930 — NEW HORIZONS WOMENS HEALTH
Practice Location Address:

13685 DOCTORS WAY , SUITE 170
FORT MYERS, FL
33912-4336

Practice Phone: 239-245-8280
Practice Fax: 239-768-8631

1336353135 — JOHN J GREEN DO PA
Practice Location Address:

14131 METROPOLIS AVENUE , SUITE 104
FORT MYERS, FL
33912-4336

Practice Phone: 239-332-4099
Practice Fax: 239-332-4088

Directions to “ LILIETT FRAGOSO TREJO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.