Provider Demographics
NPI:1336843473
Name:TRUJILLO, CAROLYN ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ELIZABETH
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11269 SW 58TH CT
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4520
Mailing Address - Country:US
Mailing Address - Phone:786-774-9482
Mailing Address - Fax:
Practice Address - Street 1:11269 SW 58TH CT
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-4520
Practice Address - Country:US
Practice Address - Phone:786-774-9482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9461293163WE0003X
FL11028106363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency