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1290 Weston Rd Ste 203 Weston FL 33326-1909 | |
| (954) 436-8036 | |
| (954) 949-9180 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1290 Weston Rd Ste 203, Weston, Florida |
| Authorized Official Name and Position | Yaneth Trujillo (FAMILY PHYSICIAN) |
| Authorized Official Contact | 9546759671 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1290 Weston Rd Ste 203 Weston FL 33326-1909 Ph: (954) 436-8036 | 1290 Weston Rd Ste 203 Weston FL 33326-1909 Ph: (954) 436-8036 |
| NPI Number | 1093951196 |
|---|---|
| Provider Enumeration Date | 12/20/2008 |
| Last Update Date | 02/07/2025 |
| Medicare PECOS PAC ID | 1951449784 |
|---|---|
| Medicare Enrollment ID | O20091116000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093951196 | NPI | - | NPPES |
| 279452700 | Medicaid | FL |
| Provider Name | Carlos H Romero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598862062 PECOS PAC ID: 1658478656 Enrollment ID: I20070529000181 |
| Provider Name | Yaneth Trujillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184753246 PECOS PAC ID: 1052409224 Enrollment ID: I20071126000031 |
| Provider Name | Jorge C Mora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114129210 PECOS PAC ID: 4981786084 Enrollment ID: I20080129000191 |
| Provider Name | Tanisha Del Carmen Dawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790380301 PECOS PAC ID: 5395285977 Enrollment ID: I20240910002052 |
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