Provider Demographics
NPI:1588197974
Name:ROJAS, MARANGELLY
Entity Type:Individual
Prefix:
First Name:MARANGELLY
Middle Name:
Last Name:ROJAS
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 1:55 CALLE DEL CARMEN W
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-4717
Mailing Address - Country:US
Mailing Address - Phone:787-860-3558
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE RVDO DOMINGO APT 6N
Practice Address - Street 2:CONDOMINIO BEATRIZ LA SALLE
Practice Address - City:SANJUAN
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-435-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR71141163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse