Individual provider Active NPI

Sophie Trujillo

  • Gastroenterology Physician
  • Port St Lucie, FL
National Provider Identifier
1306306014
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS23635 Issued in FL
Practice address
10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129
Phone
(772) 398-1800
Fax
(772) 398-1820
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X OS23635 FL Primary

Addresses

Primary practice location

10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129

Mailing address

10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129
Phone (727) 398-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trujils3@ccf.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001465 OH Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 3870827686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1306306014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY STE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872129",
            "telephone_number": "727-398-1800",
            "fax_number": "727-398-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 SW INNOVATION WAY STE 201",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872129",
            "telephone_number": "772-398-1800",
            "fax_number": "772-398-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "SOPHIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "OS23635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trujils3@ccf.org",
            "affiliation": "N",
            "address_1": "10080 SW Innovation Way Ste 201",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349872129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.