Individual provider Active NPI

Carolyn Elizabeth Trujillo, APRN

  • Acute Care Nurse Practitioner
  • Cooper City, FL
National Provider Identifier
1336843473
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11028106 Issued in FL
Practice address
11269 SW 58TH CT
Cooper City, FL 33330-4520
Phone
(786) 774-9482
NPI assigned
Mar 30, 2023
Last updated
Apr 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 11028106 FL Primary
Emergency Registered Nurse 163WE0003X 9461293 FL

Addresses

Primary practice location

11269 SW 58TH CT
Cooper City, FL 33330-4520

Mailing address

11269 SW 58TH CT
Cooper City, FL 33330-4520
Phone (786) 774-9482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722001283 FL Practitioner - Nurse Practitioner 5991241457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Emergency Physician Services of South Dade, IncGroup PAC ID 6305849449, 41 clinicians

Practice addresses (Care Compare)

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9461293FLMDEmergency Registered Nurse
11028106FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Emergency Physician Services of South Dade Inc CurrentSince Jun 8, 2024 Accepting new patients

Locations

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1336843473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11269 SW 58TH CT",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333304520",
            "telephone_number": "786-774-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11269 SW 58TH CT",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333304520",
            "telephone_number": "786-774-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "CAROLYN",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11028106",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "9461293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

Verify at the official NPI Registry.