Provider Demographics
NPI:1083606362
Name:ROJAS-DIAZ, ELI SAMUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELI
Middle Name:SAMUEL
Last Name:ROJAS-DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 PONCE DE LEON AVE.
Mailing Address - Street 2:COND. MIDTOWN STE 801
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3408
Mailing Address - Country:US
Mailing Address - Phone:787-753-9204
Mailing Address - Fax:787-751-2802
Practice Address - Street 1:420 PONCE DE LEON AVE.
Practice Address - Street 2:COND. MIDTOWN STE 801
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3408
Practice Address - Country:US
Practice Address - Phone:787-753-9204
Practice Address - Fax:787-751-2802
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR2866207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C78035Medicare PIN
PRC78035Medicare UPIN
PR0093463Medicare UPIN