Provider Demographics
NPI:1114099652
Name:ROJAS, PEDRO
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:ROJAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16524 NW 77TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3433
Mailing Address - Country:US
Mailing Address - Phone:305-343-7621
Mailing Address - Fax:305-823-7880
Practice Address - Street 1:2285 W 80TH ST
Practice Address - Street 2:BAY 3
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5579
Practice Address - Country:US
Practice Address - Phone:305-823-7770
Practice Address - Fax:305-823-7880
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1283830001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO