Provider Demographics
NPI:1376395129
Name:ROJAS-BURGOS, MAGDA
Entity Type:Individual
Prefix:
First Name:MAGDA
Middle Name:
Last Name:ROJAS-BURGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7738 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48210-1905
Mailing Address - Country:US
Mailing Address - Phone:313-434-2398
Mailing Address - Fax:
Practice Address - Street 1:7738 DAYTON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210-1905
Practice Address - Country:US
Practice Address - Phone:313-434-2398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide