Provider Demographics
NPI:1568709897
Name:TROLLERUD, VERONICA E
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:E
Last Name:TROLLERUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11407 SW 110TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3156
Mailing Address - Country:US
Mailing Address - Phone:305-546-0872
Mailing Address - Fax:
Practice Address - Street 1:11407 SW 110TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-3156
Practice Address - Country:US
Practice Address - Phone:305-546-0872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2968171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist