Provider Demographics
NPI:1154929982
Name:TRUJILLO, PATRICIA MARIE (MS)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 SW 72ND ST STE 225
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5494
Mailing Address - Country:US
Mailing Address - Phone:786-953-8389
Mailing Address - Fax:786-953-8483
Practice Address - Street 1:9425 SW 72ND ST STE 225
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5494
Practice Address - Country:US
Practice Address - Phone:786-953-8389
Practice Address - Fax:786-953-8483
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ9884OtherLICENSE