Provider Demographics
NPI:1477920957
Name:ELIAS-TRUJILLO, ROSAURA (CRNA)
Entity Type:Individual
Prefix:
First Name:ROSAURA
Middle Name:
Last Name:ELIAS-TRUJILLO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 SUMMIT CREEK BLVD APT 7301
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4505
Mailing Address - Country:US
Mailing Address - Phone:787-438-7828
Mailing Address - Fax:
Practice Address - Street 1:4213 SUMMIT CREEK BLVD APT 7301
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4505
Practice Address - Country:US
Practice Address - Phone:787-438-7828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9407825367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered