Provider Demographics
NPI:1619432192
Name:BORJA, JANINE BEATRICE GOZA (MD)
Entity Type:Individual
Prefix:
First Name:JANINE BEATRICE
Middle Name:GOZA
Last Name:BORJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANINE BEATRICE
Other - Middle Name:JOSE
Other - Last Name:GOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8080 EDEN RD APT 158
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7675
Mailing Address - Country:US
Mailing Address - Phone:612-413-1512
Mailing Address - Fax:
Practice Address - Street 1:8201 E RIVERSIDE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-2300
Practice Address - Country:US
Practice Address - Phone:815-971-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program