Provider Demographics
NPI:1760011001
Name:ROJAS DONOSO, FABIO HUMBERTO (MS)
Entity Type:Individual
Prefix:
First Name:FABIO
Middle Name:HUMBERTO
Last Name:ROJAS DONOSO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 GLIDING WAVE ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-9088
Mailing Address - Country:US
Mailing Address - Phone:786-812-8046
Mailing Address - Fax:863-216-6595
Practice Address - Street 1:101 S DIXIE DR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-2844
Practice Address - Country:US
Practice Address - Phone:863-216-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral