Individual ProviderLupita L Trujillo-ThiemanPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3901 University Blvd S, Jacksonville, FL 32216-4312(904) 858-7200(904) 739-1103PECOS EnrollmentBased on the most recent information from CMS, provider Lupita L Trujillo-Thieman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1285809483Provider TypeIndividualFull NameTrujillo-Thieman, Lupita LCredentialMPTGenderFemaleSole ProprietorNoEnumeration Date4/28/2008Last Updated4/28/2008Contact InformationPractice LocationPractice Address3901 University Blvd S, Jacksonville, FL 32216-4312Phone(904) 858-7200FaxUnlisted FaxMailing LocationMailing Address3043 Indian Hill Dr, Jacksonville, FL 32257-5722Phone(904) 739-1103FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT11177Florida