Provider Demographics
NPI:1356878912
Name:TRUMBO, SILAS (MD)
Entity type:Individual
Prefix:DR
First Name:SILAS
Middle Name:
Last Name:TRUMBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7665
Mailing Address - Country:US
Mailing Address - Phone:407-266-3627
Mailing Address - Fax:407-266-4911
Practice Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 160
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7665
Practice Address - Country:US
Practice Address - Phone:407-266-3627
Practice Address - Fax:407-266-4911
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME161546207R00000X
TN58715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine