MEDICARE: MRS. MAIRELYS ELVIRA OLIVERA TRUJILLO APRN-FNP-C

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	363L00000X	Nurse Practitioner	APRN11042156	FL

General Provider Information

NPI Number	:	1477424497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAIRELYS ELVIRA OLIVERA TRUJILLO APRN-FNP-C

Provider Business Mailing Address
First Line	:	4023 14TH AVE SE
Second Line	:	4023 14TH AVE SE
City	:	NAPLES
State	:	FL
Zip	:	34117-9106
Country	:	US
Telephone Number	:	239-465-5692
Fax Number	:

Provider Business Practice Location Address
First Line	:	4023 14TH AVE SE
Second Line	:	4023 14TH AVE SE
City	:	NAPLES
State	:	FL
Zip	:	34117-9106
Country	:	US
Telephone Number	:	239-465-5692
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	01/07/2026

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